Provider Demographics
NPI:1578836094
Name:MORROW, SHANNON ELIZABETH (MS)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:ELIZABETH
Last Name:MORROW
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:ELIZABETH
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 S VICTORIA AVE # L4640
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93009-0002
Mailing Address - Country:US
Mailing Address - Phone:805-524-2000
Mailing Address - Fax:805-524-9601
Practice Address - Street 1:300 HILLMONT AVENUE, BLDG. 340, SUITE 401
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3099
Practice Address - Country:US
Practice Address - Phone:805-652-6201
Practice Address - Fax:805-641-4416
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53213363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant