MR. MARK JAY SHANNON (NPI# 1225367519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225367519 |
| Entity Type | Individual |
| Full Name | MR. MARK JAY SHANNON |
| Credential | P.A. |
| Practice Address |
1201 Alhambra Blvd Suite 400 Sacramento CA 95816-5238 |
| Mailing Address |
10470 Old Placerville Rd Suite 100 Sacramento CA 95827-2539 |
| Practice Telephone | 9167335090 |
| Practice Fax Number | 9167335062 |
| Mailing Telephone | 8004700071 |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2013-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA12702 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA # | MS1228154 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508941089 | Mark Shannon | Internal Medicine | 42 Lincoln Ave, Barrington, RI 02806-2136 | 2006-10-25 |
| Street Address |
1201 ALHAMBRA BLVD SUITE 400 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95816-5238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265439103 | Tyler Elliott Harris | Orthopaedic Surgery | 1201 Alhambra Blvd, Sacramento, CA 95816-5243 | 2005-07-07 |
| 1578192472 | Travis Vermilya Hays | Student in an Organized Health Care Education/Training Program | 1201 Alhambra Blvd, Sacramento, CA 95816-5238 | 2020-04-03 |
| 1053940924 | Kate Grayson Meizlish | Student in an Organized Health Care Education/Training Program | 1201 Alhambra Blvd, Sacramento, CA 95816-5238 | 2020-04-03 |
| 1871122747 | Soo Kyung Hwang | Student in an Organized Health Care Education/Training Program | 1201 Alhambra Blvd, Sacramento, CA 95816-5238 | 2020-04-03 |
| 1427617117 | Jennifer Goldberg | Student in an Organized Health Care Education/Training Program | 1201 Alhambra Blvd, Sacramento, CA 95816-5238 | 2019-06-06 |
| 1144711797 | Felicia Tang | Student in an Organized Health Care Education/Training Program | 1201 Alhambra Blvd, Sacramento, CA 95816-5238 | 2018-05-18 |
| 1720508401 | Xaunna Jade Krehn | Student in an Organized Health Care Education/Training Program | 1201 Alhambra Blvd, Sacramento, CA 95816-5238 | 2017-06-22 |
| 1962873513 | Sacramento Hand Rehabilitation Inc | Occupational Therapist | 1201 Alhambra Blvd, 410, Sacramento, CA 95816-5238 | 2015-10-08 |
| 1124407275 | Ron Martin Garcia Menorca | Family Medicine | 1201 Alhambra Blvd, Sacramento, CA 95816-5238 | 2015-05-21 |
| 1356784896 | Rick Hong | Family Medicine | 1201 Alhambra Blvd, Suite 340, Sacramento, CA 95816-5238 | 2013-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1417418955 | Soraya Foutouhi | Student in an Organized Health Care Education/Training Program | 301 C Street, Suite 1400, Sacramento, CA 95816 | 2019-03-27 |
| 1265902704 | Daljit Girn | Behavior Technician | 1315 Alhambra Blvd Ste 110, Sacramento, CA 95816 | 2018-11-27 |
| 1609385178 | Jared James Harold-husted | Behavior Technician | 3031 C St, Sacramento, Sacramento, CA 95816 | 2017-09-27 |
| 1124537170 | Phuong Huynh | Behavior Technician | 3009 C Street, Sacramento, CA 95816 | 2017-09-21 |
| 1427570811 | Manpreet Kaur Chehal | Counselor | 500 22nd Street, Sacramento, CA 95816 | 2017-07-07 |
| 1295264646 | Veronica Lynn Just | Behavior Technician | 3031 C St., Sacramento, CA 95816 | 2017-06-08 |
| 1285163907 | Marquise Jones | Behavior Technician | 3031 C Street, Sacramento, CA 95816 | 2017-06-06 |
| 1578007159 | Kate Hanel | Student in an Organized Health Care Education/Training Program | 2500 I St, Sacramento, CA 95816 | 2016-12-15 |
| 1184174534 | Jennifer M Stegner | Nurse Practitioner | 1625 Stockton Blvd #104, Sacramento, CA 95816 | 2016-10-10 |
| Find all providers in zip 95816 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1548740541 | Genevieve Clara Towne | Physician Assistant | 4132 B St, Sacramento, CA 95819-2121 | 2018-08-19 |
| 1841577863 | Amy R. Quarre | Physician Assistant | 2408 Q St Apt 1, Sacramento, CA 95816-6837 | 2011-11-04 |
| 1356673214 | Gay D Ayers | Physician Assistant | 4460 Duckhorn Dr, Sacramento, CA 95834-2593 | 2010-02-03 |
| 1477795805 | Flene A Folsom | Physician Assistant | 4400 Duckhorn Drive, Sacramento, CA 95834 | 2009-03-31 |
| 1154566552 | Mikhail G Karton | Physician Assistant | 701 Howe Ave Ste C1, Sacramento, CA 95825-4670 | 2008-12-13 |
| 1881603629 | Ja Yang | Physician Assistant | 3811 Florin Rd Ste 9, Sacramento, CA 95823-1818 | 2006-08-07 |
| 1801899836 | Sarah L Zichella | Physician Assistant | 2801 K St, Suite 410, Sacramento, CA 95816-5120 | 2005-05-23 |
| 1285247049 | Thanh Trung Pham | Physician Assistant | 4610 X St, Sacramento, CA 95817-2200 | 2020-08-30 |
| 1760092688 | Keoki Lawrence Goeas Leong | Physician Assistant | 4610 X St, Sacramento, CA 95817-2200 | 2020-08-05 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95816 |
Please comment or provide details below to improve the information on MR. MARK JAY SHANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.