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SHANNON SULLIVAN RN
NPI 1922574920
Psychologist - Prescribing (Medical) in Tracy, CA

Active since October 17, 2018
20 E EATON AVE, TRACY, CA 95376(209) 553-0737 Get Directions Write a Review

NPPES record last updated: May 3, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 3, 2018, Oct 17, 2018 (2 updates tracked since 2018).

About Shannon Sullivan Rn NPPES

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

SHANNON SULLIVAN RN (NPI 1922574920) is an individual prescribing (medical) provider in Tracy, California and active in the NPI registry since October 2018.

NPPES Registry Identity

NPI1922574920
Entity TypeIndividualFemale
Primary Taxonomy103TP0016X
Provider Legal NameSHANNON SULLIVANCredential: RN
Location Address20 E EATON AVETracy, CA 95376-3100
Mailing Address20 E Eaton AveTracy, CA 95376-3100 · (209) 553-0737
Phone(209) 553-0737
Sole ProprietorNo
Enumeration DateOctober 17, 2018
Last NPPES UpdateMay 3, 20252 updates tracked since enumeration
NPPES CertifiedMay 3, 2025
✔ NPI 1922574920 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Prescribing (Medical)Behavioral Health & Social Service Providers
Taxonomy Code103TP0016X
Definition

A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.

Also ListedRegistered NurseTaxonomy 163W00000X · License 789456 (IA)
20 E EATON AVE, Tracy, CA 95376
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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 Sullivan's NPI number?

The NPI number for Shannon Sullivan is 1922574920. It was assigned to this individual provider in the NPPES registry on October 17, 2018.

Where is Shannon Sullivan located?

Shannon Sullivan practices at 20 E Eaton Ave, Tracy, CA 95376. The listed phone number is (209) 553-0737.

What is Shannon Sullivan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Prescribing (Medical), with taxonomy code 103TP0016X.

When was this NPI record last updated?

The NPPES record for Shannon Sullivan was last updated on May 3, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.