Search › California › 251S00000X
Shane Clontz
NPI 1669232518 · on the registry since 2024 · sole proprietor
Practice
- Address
- 942 Cedarcrest Dr
Vacaville, CA 95687 - Phone
- (503) 462-5388
- Organisation at this address
- Convergence Life
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 251S00000X
251S00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-03-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California