SHANNON MARIE WISEMAN - NPI 1164696597 - Counselor in Santa Rosa, CA

Q: What is Shannon Wiseman's NPI number?

The NPI number for Shannon Wiseman is 1164696597. It was assigned to this individual provider in the NPPES registry on April 16, 2008.

Q: What is Shannon Wiseman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Wiseman was last updated on September 1, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Shannon Marie Wiseman NPPES

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

SHANNON MARIE WISEMAN (NPI 1164696597) is an individual mental health provider in Santa Rosa, California and active in the NPI registry since April 2008.

NPPES Registry Identity

NPI1164696597

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameSHANNON MARIE WISEMAN

Location Address3164 CONDO CTSanta Rosa, CA 95403-2557

Mailing Address341 Irwin LnSanta Rosa, CA 95401-5603 · (707) 576-7218 · Fax (707) 360-1540

Phone(707) 523-2334

Fax(707) 360-1540

Sole ProprietorNo

Enumeration DateApril 16, 2008

Last NPPES UpdateSeptember 1, 2009

✔ NPI 1164696597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

3164 CONDO CT, Santa Rosa, CA 95403

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Other Providers at the Same Location NPPES 20

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

MS. FRANCINE R ROBERTSON

Counselor (Mental Health)