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NPI Code Detail

MEDICARE: MISS SHANNON L PLUMMER ASW

MEDICARE: MISS SHANNON L PLUMMER ASW
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
11041C0700XClinical Social Worker73312CA

General Provider Information

NPI Number : 1528555737
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SHANNON L PLUMMER ASW
Provider Business Mailing Address
First Line : 8391 AUBURN BLVD
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-0364
Country : US
Telephone Number : 916-923-5444
Fax Number : 916-923-2365
Provider Business Practice Location Address
First Line : 8391 AUBURN BLVD
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-0364
Country : US
Telephone Number : 916-923-5444
Fax Number : 916-923-2365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2018
Last Update Date : 04/13/2018

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