Provider Demographics
NPI:1477840734
Name:LIANG, SHANNON NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:NICOLE
Last Name:LIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:726 N MEDICAL CENTER DR E STE 209
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6886
Practice Address - Country:US
Practice Address - Phone:559-325-5656
Practice Address - Fax:559-325-5568
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2023-07-01
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Provider Licenses
StateLicense IDTaxonomies
CAA1411332084N0402X, 282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology