Provider Demographics
NPI:1407987514
Name:STRAIN, SHANNON DEE (SUDCC IV)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:DEE
Last Name:STRAIN
Suffix:
Gender:F
Credentials:SUDCC IV
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:DEE
Other - Last Name:STRAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SUDCC IV
Mailing Address - Street 1:2940 INLAND EMPIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4898
Mailing Address - Country:US
Mailing Address - Phone:909-458-1373
Mailing Address - Fax:909-944-1059
Practice Address - Street 1:2940 INLAND EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4898
Practice Address - Country:US
Practice Address - Phone:909-458-1373
Practice Address - Fax:909-944-1059
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)