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SHANNON BENNETT-GUNDERSON
NPI 1073054334
Nurse Practitioner - Family in San Diego, CA

Active since March 19, 2017
5717 PACIFIC CENTER BLVD STE 200, SAN DIEGO, CA 92121(858) 859-1188 Get Directions Write a Review

NPPES record last updated: May 10, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 10, 2019, Jul 10, 2018, Mar 19, 2017 (3 updates tracked since 2017).

About Shannon Bennett-gunderson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON BENNETT-GUNDERSON (NPI 1073054334) is an individual family provider in San Diego, California, licensed in California (95005012) and active in the NPI registry since March 2017. She maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1073054334
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANNON BENNETT-GUNDERSON
Location Address5717 PACIFIC CENTER BLVD STE 200San Diego, CA 92121-4250
Mailing Address7875 Highland Village Pl, B102-244San Diego, CA 92129-5189 · (858) 688-6968
Phone(858) 859-1188
Sole ProprietorYes
Enumeration DateMarch 19, 2017
Last NPPES UpdateMay 10, 20193 updates tracked since enumeration
✔ NPI 1073054334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in CA · 95005012✔ Licensed in CA · 536000
5717 PACIFIC CENTER BLVD STE 200, San Diego, CA 92121
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Secondary Practice Location 1

Location 17875 Highland Village Pl, B102-244San Diego, CA 92129-5189 · Phone (858) 688-6968

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GINGER R LUCERO PA-C
Physician Assistant
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188
MS. MERISSA ANNE FERRARO AGNP-BC
Nurse Practitioner (Adult Health)
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188
JILL CHANG PA-C
Physician Assistant (Medical)
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188
ELIZABETH HAUG PA-C
Physician Assistant
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188
REBECCA PRAKASH CRNP
Nurse Practitioner
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188
MELISSA MUSSO NP-C
Nurse Practitioner (Family)
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188
JAMIE L EVERT PA
Physician Assistant
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188
CONGWEI SALO MHS, PA-C
Physician Assistant
5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA 92121
San Diego County (858) 859-1188

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Bennett-gunderson's NPI number?

The NPI number for Shannon Bennett-gunderson is 1073054334. It was assigned to this individual provider in the NPPES registry on March 19, 2017.

Where is Shannon Bennett-gunderson located?

Shannon Bennett-gunderson practices at 5717 Pacific Center Blvd Ste 200, San Diego, CA 92121. The listed phone number is (858) 859-1188.

What is Shannon Bennett-gunderson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Shannon Bennett-gunderson was last updated on May 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.