Provider Demographics
NPI:1003417478
Name:DOSS, SHANNON GIOVANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:GIOVANNA
Last Name:DOSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:GIOVANNA
Other - Last Name:BOWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1794
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-1294
Mailing Address - Country:US
Mailing Address - Phone:424-232-2795
Mailing Address - Fax:
Practice Address - Street 1:3736 PALM AVE
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-5103
Practice Address - Country:US
Practice Address - Phone:424-232-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1034191041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical