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General NPI Number Information
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NPI Number | 1588964159
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Entity Type | Organization
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Legal Business Name | NURSE PRACTITIONERS OF CALIFORNIA
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 25105 CLOVER CREEK LN
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City | MENIFEE
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State | CA
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Zip | 92584-8456
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Country | US
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Telephone | 951-852-8505
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Fax | 951-746-3496
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Provider Business Mailing Address
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Address Line | 26025 NEWPORT ROAD SUITE A 305
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City | MENIFEE
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State | CA
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Zip | 92584
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Country | UM
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Telephone | 951-852-8505
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Fax | 951-746-3496
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Authorized Official
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Title or Position | FOUNDER
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Name | DEBORAH LOUISE SHANNON
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Credential | N.P.
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Telephone | 951-852-8505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 18946
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18946
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License Number State | CA
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