Provider Demographics
NPI:1558659995
Name:PIPER, SHANNON JUNE (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:SHANNON
Middle Name:JUNE
Last Name:PIPER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 EAST CARSON STREE
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932
Mailing Address - Country:US
Mailing Address - Phone:530-458-0520
Mailing Address - Fax:530-458-7751
Practice Address - Street 1:162 EAST CARSON STREET
Practice Address - Street 2:SUITE A
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932
Practice Address - Country:US
Practice Address - Phone:530-458-0520
Practice Address - Fax:530-458-7751
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 53966106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist