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NPI Code Detail

MEDICARE: SHANNON HE

MEDICARE: SHANNON HE
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
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0800XPsychiatry PhysicianA200152CA

General Provider Information

NPI Number : 1730881327
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON HE
Provider Business Mailing Address
First Line : 275 W MACARTHUR BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94611-5641
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 275 W MACARTHUR BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94611-5641
Country : US
Telephone Number : 510-752-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2023
Last Update Date : 04/08/2026

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Directions to “ SHANNON HE ” Practice Location

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