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NPI Code Detail

MEDICARE: MS. SHANNON LESLIE DURAND BCBA

MEDICARE: MS. SHANNON LESLIE DURAND BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst0-10-3849

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10-10-3849OTHERTXBEHAVIOR ANALYST CERTIFICATION BOARD, INC.

General Provider Information

NPI Number : 1245543180
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON LESLIE DURAND BCBA
Provider Business Mailing Address
First Line : 228 HAMILTON AVE FL 3
Second Line :
City : PALO ALTO
State : CA
Zip : 94301-2583
Country : US
Telephone Number : 254-715-9536
Fax Number :
Provider Business Practice Location Address
First Line : 228 HAMILTON AVE FL 3
Second Line :
City : PALO ALTO
State : CA
Zip : 94301-2583
Country : US
Telephone Number : 254-715-9536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2010
Last Update Date : 06/28/2025

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