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General NPI Number Information
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NPI Number | 1780175356
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Entity Type | Individual
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Provider Name | SHANNON ENOCHS DNP, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/19/2018
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 1100 FLYNN RD UNIT 201
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City | CAMARILLO
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State | CA
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Zip | 93012-8741
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Country | US
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Telephone | 805-229-1288
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Fax | 805-618-2898
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Provider Business Mailing Address
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Address Line | 1100 FLYNN RD UNIT 201
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City | CAMARILLO
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State | CA
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Zip | 93012-8741
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Country | US
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Telephone | 805-229-1288
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95011453
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License Number State | CA
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