Provider Demographics
NPI:1124195227
Name:HUFFAKER, SHANNON D'AUN (NP)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:D'AUN
Last Name:HUFFAKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 SANCHEZ ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1616
Mailing Address - Country:US
Mailing Address - Phone:415-864-1235
Mailing Address - Fax:
Practice Address - Street 1:25 VAN NESS AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6033
Practice Address - Country:US
Practice Address - Phone:415-554-9343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA659238163W00000X
CA16165363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health