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General NPI Number Information
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NPI Number | 1114874435
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Entity Type | Individual
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Provider Name | SHAUNA-DENE SMALL LEP
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 3628 SACRAMENTO ST STE 3
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1719
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Country | US
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Telephone | 415-669-4887
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 410821
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City | SAN FRANCISCO
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State | CA
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Zip | 94141-0821
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 4454
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License Number State | CA
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