Provider Demographics
NPI:1700235454
Name:ACCARDO, SHANNON ANNALEE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:ANNALEE
Last Name:ACCARDO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:A
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:659 W SHAW AVE STE C
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2442
Mailing Address - Country:US
Mailing Address - Phone:559-519-4525
Mailing Address - Fax:
Practice Address - Street 1:659 W SHAW AVE STE C
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2442
Practice Address - Country:US
Practice Address - Phone:559-226-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106079106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist