Shannahan, Jill

Shannahan, Jill is an individual health care provider with primary practice located at 1400 Emeline Ave , Santa Cruz CA 95060-1976. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Shannahan, Jill can be contacted via phone (831) 454-4170.

Contact Information

Primary practice address
1400 Emeline Ave Santa Cruz CA 95060-1976
Phone: (831) 454-4170
Fax: (831) 454-4663
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X G83206 California

Profile Details

NPI number 1467516005
LBN Legal business name Shannahan, Jill
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2006
Last updated Mar 7th, 2023 - about 2 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 1467516005 NPPES
California MEDICAID 00G832061
California Other ZZZ91891Z
California Other ZZZ92069Z
California Other G83206
California Other ZZZ91892Z
California Other ZZZ92073Z

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