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General NPI Number Information
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NPI Number | 1619791332
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Entity Type | Individual
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Provider Name | SHANA MCDAVIS-CONWAY ASW
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Gender | Female
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Dates
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Enumeration Date | 11/09/2024
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Last Update Date | 06/07/2025
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Provider Practice Location Address
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Address Line | 2150 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-1337
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Country | US
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Telephone | 916-875-1145
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Fax |
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Provider Business Mailing Address
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Address Line | 7451 AUBURN BLVD # 1020
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-2992
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Country | US
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Telephone | 916-520-9335
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | ASW125616
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | ASW125616
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License Number State | CA
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