Provider Demographics
NPI:1265130082
Name:QUIJANO, SHANNON SHEA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:SHEA
Last Name:QUIJANO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 OVERPARK RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-1829
Mailing Address - Country:US
Mailing Address - Phone:281-610-3104
Mailing Address - Fax:
Practice Address - Street 1:3750 OVERPARK RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-1829
Practice Address - Country:US
Practice Address - Phone:281-610-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA732621835P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0200XPharmacy Service ProvidersPharmacistPediatrics