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:
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Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295922912 NPPES
California Other 00000 MEDICAL

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