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NPI Code Detail

MEDICARE: SHANNA ELISABETH STEVENS CBD

MEDICARE:   SHANNA ELISABETH STEVENS  CBD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
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General Provider Information

NPI Number : 1154270981
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNA ELISABETH STEVENS CBD
Provider Business Mailing Address
First Line : 2250 VANGUARD WAY APT A201
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-6591
Country : US
Telephone Number : 360-914-8328
Fax Number :
Provider Business Practice Location Address
First Line : 2250 VANGUARD WAY APT A201
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-6591
Country : US
Telephone Number : 360-914-8328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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Directions to “ SHANNA ELISABETH STEVENS CBD” Practice Location

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