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Shannon Lara Smith
Student in an Organized Health Care Education/Training Program in Berkeley, California
NPI 1336329564

Shannon Lara Smith is a Student in an Organized Health Care Education/Training Program based in Berkeley, CA. Shannon Lara Smith practices in Berkeley, CA. The NPI Number for Shannon Lara Smith is 1336329564 and holds a License No. (California).

The current practice location address for Shannon Lara Smith is 3200 Adeline Street, Berkeley, CA and can be reached out via phone at 415-859-6264.

Location: 3200 Adeline Street, Berkeley, CA, 94703-2407
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336329564
Provider Name
Shannon Lara Smith
Credential
Provider Entity Type
Individual
Gender
Female
Address
3200 Adeline Street, Berkeley, CA, 94703-2407
Phone Number
415-859-6264
Fax Number
Provider Enumeration Date
11/05/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3200 Adeline Street
City
Berkeley
State
California
Zip
94703-3501
Phone Number
415-859-6264
Fax Number
person
Provider Business Mailing Address Details
Address
3200 Adeline Street
City
Berkeley
State
California
Zip
94703-3501
Phone Number
415-859-6264
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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