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General NPI Number Information
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NPI Number | 1578135158
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Entity Type | Individual
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Provider Name | SHANNON VICTORIA SKOWBO
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Gender | Female
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 22533 FOOTHILL BLVD
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City | HAYWARD
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State | CA
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Zip | 94541-4109
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Country | US
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Telephone | 510-732-7881
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Fax |
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Provider Business Mailing Address
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Address Line | 22533 FOOTHILL BLVD
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City | HAYWARD
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State | CA
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Zip | 94541-4109
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Country | US
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Telephone | 209-617-6051
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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 | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OTH-009689
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 27993
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License Number State | CA
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