ETHAN ALVA SHEPPARD

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1063370799

Practice Address

2180 JOHNSON AVE
San Luis Obispo, CA 93401

Phone: (805) 781-4768

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes -

Frequently Asked Questions

NPI 1063370799 is the National Provider Identifier for ETHAN ALVA SHEPPARD, a Counselor - Addiction (Substance Use Disorder) provider located in San Luis Obispo, CA. This NPI was enumerated on January 12, 2026.
ETHAN ALVA SHEPPARD practices at 2180 JOHNSON AVE, San Luis Obispo, CA 93401.

Quick Facts

NPI
1063370799
Type
Individual
Enumerated
Jan 12, 2026
Last Updated
Jan 12, 2026

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