Provider Demographics
NPI:1831145002
Name:SHAPPELL, PATRICIA WEIS (AUD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:WEIS
Last Name:SHAPPELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 KOLL CENTER PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-8061
Mailing Address - Country:US
Mailing Address - Phone:949-713-3998
Mailing Address - Fax:949-713-2931
Practice Address - Street 1:6701 KOLL CENTER PKWY STE 120
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8061
Practice Address - Country:US
Practice Address - Phone:949-713-3998
Practice Address - Fax:949-713-2931
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD805231H00000X
CAAU2958231H00000X
GAAUD003980231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist