Provider Demographics
NPI:1437599768
Name:PERRY, SHANNON DEANNE
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:DEANNE
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:DEANNE
Other - Last Name:SCHWEITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3401 E BAYSHORE RD
Mailing Address - Street 2:#F7
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-4694
Mailing Address - Country:US
Mailing Address - Phone:650-281-5425
Mailing Address - Fax:
Practice Address - Street 1:1818 GILBRETH RD
Practice Address - Street 2:SUITE 230
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1225
Practice Address - Country:US
Practice Address - Phone:650-348-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)