MEDICARE: SHANNON ROSE BARRETT PT, DPT

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
1	225100000X	Physical Therapist	305303	CA

General Provider Information

NPI Number	:	1467229526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON ROSE BARRETT PT, DPT

Provider Business Mailing Address
First Line	:	PO BOX 541
Second Line	:
City	:	SUMMERLAND
State	:	CA
Zip	:	93067-0541
Country	:	US
Telephone Number	:	916-410-6150
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 COAST VILLAGE RD STE D
Second Line	:
City	:	MONTECITO
State	:	CA
Zip	:	93108-2720
Country	:	US
Telephone Number	:	805-222-0271
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2023
Last Update Date	:	09/28/2025

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