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NPI Code Detail

MEDICARE: SHAWNELL ALFORD

MEDICARE: SHAWNELL ALFORD
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
1101YA0400XAddiction (Substance Use Disorder) CounselorR1285291217CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R1285291217OTHERCACCAPP

General Provider Information

NPI Number : 1417463506
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWNELL ALFORD
Provider Business Mailing Address
First Line : 1001 GRAND AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-3512
Country : US
Telephone Number : 916-929-1951
Fax Number :
Provider Business Practice Location Address
First Line : 1001 GRAND AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95838-3512
Country : US
Telephone Number : 916-929-1951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2017
Last Update Date : 12/27/2017

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Directions to “ SHAWNELL ALFORD ” Practice Location

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