Provider Demographics
NPI:1497969992
Name:SHANNON, VICTORIA S
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:S
Last Name:SHANNON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2632
Mailing Address - Country:US
Mailing Address - Phone:831-229-3404
Mailing Address - Fax:
Practice Address - Street 1:130 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2632
Practice Address - Country:US
Practice Address - Phone:831-229-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor