Clark, Shannon
Clark, Shannon is an individual health care provider with primary practice located at 4860 Y St Suite 2500, Sacramento CA 95817-2307. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics, Allopathic & Osteopathic Physicians / Behavioral Neurology & Neuropsychiatry. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Clark, Shannon can be contacted via phone (916) 734-8445.Contact Information
Primary practice address
4860 Y St Suite 2500
Sacramento CA 95817-2307
Phone: (916) 734-8445
Fax: (916) 734-6666
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A103021 | California |
| Allopathic & Osteopathic Physicians / Obstetrics | 207VX0000X | A103021 | California |
| Allopathic & Osteopathic Physicians / Behavioral Neurology & Neuropsychiatry | 2084B0040X | A103121 | California |
Profile Details
| NPI number | 1295922912 |
|---|---|
| LBN Legal business name | Clark, Shannon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2007 |
| Last updated | Jul 17th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295922912 | NPPES |
| California | Other | 00000 | MEDICAL |
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