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General NPI Number Information
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NPI Number | 1629359070
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Entity Type | Individual
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Provider Name | SHANNON A BERTSCHE PA-C, MPAS
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Gender | Female
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 1441 CONSTITUTION BLVD BUILDING SUITE 300
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City | SALINAS
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State | CA
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Zip | 93906
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Country | US
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Telephone | 831-755-4123
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 CONSTITUTION BLVD BUILDING 400 SUITE 300
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City | SALINAS
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State | CA
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Zip | 93906
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Country | US
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Telephone | 402-202-5605
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA22926
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License Number State | CA
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