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General NPI Number Information
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NPI Number | 1740164086
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Entity Type | Individual
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Provider Name | DEJANEE SHANKLIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 4451 30TH ST
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City | SAN DIEGO
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State | CA
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Zip | 92116-4232
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Country | US
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Telephone | 619-837-5799
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Fax |
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Provider Business Mailing Address
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Address Line | 705 S 45TH ST
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City | SAN DIEGO
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State | CA
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Zip | 92113-2906
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Country | US
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Telephone | 619-549-7577
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 131180
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License Number State | CA
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