Provider Demographics
NPI:1336344811
Name:O'FLINN, SHANNON COUTURE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:COUTURE
Last Name:O'FLINN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:MARIE
Other - Last Name:COUTURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:482 N ROSEMEAD BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3053
Mailing Address - Country:US
Mailing Address - Phone:720-206-6462
Mailing Address - Fax:
Practice Address - Street 1:482 N ROSEMEAD BLVD STE 207
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3053
Practice Address - Country:US
Practice Address - Phone:720-206-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24779103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical