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General NPI Number Information
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NPI Number | 1710483870
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Entity Type | Individual
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Provider Name | MS. SHAWNTEE DENISE PARKER
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Gender | Female
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 9738 LINCOLN VILLAGE DR STE 120
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City | SACRAMENTO
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State | CA
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Zip | 95827-3380
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Country | US
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Telephone | 916-714-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 5836 DUDLEY BLVD APT 230
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City | MCCLELLAN
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State | CA
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Zip | 95652-2436
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Country | US
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Telephone | 916-890-7074
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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