Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Alva Sheppard

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1063370799

Ethan Alva Sheppard is an Addiction (Substance Use Disorder) Counselor in San Luis Obispo, California. Licensed in California. Registered with an NPI since 2026.

Licensed in
CA
In the registry since
2026

Practice location Address checks out

2180 Johnson Ave
San Luis Obispo, CA 93401-4558
Phone: (805) 781-4768
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X (CA)

Record details

NPI number1063370799
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 12, 2026
Last updated in NPPESJanuary 12, 2026
Certification dateJanuary 12, 2026

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