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General NPI Number Information
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NPI Number | 1326594797
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Entity Type | Organization
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Legal Business Name | SHANAHAN & ASSOCIATES INC
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 1936 HORNBLEND ST
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City | SAN DIEGO
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State | CA
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Zip | 92109-4546
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Country | US
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Telephone | 858-581-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 1936 HORNBLEND ST
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City | SAN DIEGO
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State | CA
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Zip | 92109-4546
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Country | US
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Telephone | 858-581-6400
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. TERESA SHANAHAN
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Credential | PHD
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Telephone | 858-581-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | B1986008066
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License Number State | CA
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