Provider Demographics
NPI:1811578875
Name:LOSOYA, SHANNA SAMON (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:SAMON
Last Name:LOSOYA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 CALLAGHAN RD STE 425
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4737
Mailing Address - Country:US
Mailing Address - Phone:210-243-1055
Mailing Address - Fax:
Practice Address - Street 1:8207 CALLAGHAN RD STE 425
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4737
Practice Address - Country:US
Practice Address - Phone:210-243-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171270364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent