Healthcare Provider Details

I. General information

NPI: 1760537617
Provider Name (Legal Business Name): SHANNON RENEE GIGOUNAS MSN, RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date: 08/04/2026
Reactivation Date: 08/31/2026

III. Provider practice location address

15 RAILROAD AVE
DANVILLE CA
94526-3873
US

IV. Provider business mailing address

28 CAVALRY CT
DANVILLE CA
94526-3903
US

V. Phone/Fax

Practice location:
  • Phone: 925-330-5519
  • Fax:
Mailing address:
  • Phone: 925-330-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: