Provider Demographics
NPI:1609965664
Name:KIERAN, SHANNON M (MS)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:M
Last Name:KIERAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 SAMARITAN DR
Mailing Address - Street 2:# 20
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124
Mailing Address - Country:US
Mailing Address - Phone:602-481-1111
Mailing Address - Fax:
Practice Address - Street 1:2405 SAMARITAN DR
Practice Address - Street 2:# 20
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124
Practice Address - Country:US
Practice Address - Phone:602-481-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS