Provider Demographics
NPI:1184151359
Name:MCDOWELL, SHANNON ALEXANDRIA
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:ALEXANDRIA
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 S LOS ANGELES ST APT 517
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3784
Mailing Address - Country:US
Mailing Address - Phone:916-709-6824
Mailing Address - Fax:
Practice Address - Street 1:3460 TORRANCE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5812
Practice Address - Country:US
Practice Address - Phone:310-371-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics