SHANNON BRECKENRIDGE


Address: 1800 Tully Rd # Stua-2, Modesto, CA 95350-2946
Phone: 2096221420

SHANNON BRECKENRIDGE (NPI# 1548669500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548669500
Entity Type Individual
Full Name SHANNON BRECKENRIDGE
Other Name SHANNON TURNER
Practice Address 1800 Tully Rd # Stua-2
Modesto
CA 95350-2946
Mailing Address 972 Oak Grove Rd
Modesto
CA 95351
Practice Telephone 2096221420
Enumeration Date 2014-08-15
Last Update Date 2014-08-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
68828 CA Behavioral Health & Social Service Providers

Office Location

Street Address 1800 TULLY RD # STUA-2
City MODESTO
State CA
Zip Code 95350-2946

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164020459 Karina Montes Rodriguez Case Manager/Care Coordinator Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 2020-10-09
1134737315 Dr. Jeffrey A. Saladin, Dental Corporation Dentist 2057 Tully Road, Suite A, Modesto, CA 95350 2020-07-14
1588211254 Karla Junuen Toscano Licensed Vocational Nurse 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 2019-08-19
1831694769 Loretta Myers-weber Nurse Practitioner 1510 Florida Ave Ste A, Modesto, CA 95350 2018-03-23
1720599632 Coral Alejandra Amador Counselor 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 2017-10-18
1053820522 Pannu and Henne Dental Corp. Dentist 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 2017-09-27
1346779709 Kevin Sotelo Behavior Technician 2630 W Rumble Road, Modesto, CA 95350 2017-06-08
1255869566 Hoa Xuan Phan Family Medicine 1441 Florida Ave Ste 200, Modesto, CA 95350 2017-05-31
1356881163 Brady S Marshall Dentist 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 2017-02-27
1750755476 Caremore Health Plan Nurse Practitioner 1234 Mchenry Avenue, Modesto, CA 95350 2015-11-18
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1598378408 Amelia Ann Garcia Counselor 1004 Whitemarsh Way, Modesto, CA 95356-1237 2020-08-28
1720599632 Coral Alejandra Amador Counselor 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 2017-10-18
1720463029 Valerie Kristine Seagle Counselor 615 13th St Ste B1, Modesto, CA 95354-2456 2015-07-28
1952702706 Michelle Ann Culver Counselor 4640 Spyres Way Ste 7, Modesto, CA 95356-9800 2014-09-11
1942601398 Brianna Bossard Counselor 1231 8th St Ste 775, Modesto, CA 95354-2232 2014-09-04
1043619380 Fanny Cortez Counselor 121 Downey Ave Apt 120, Modesto, CA 95354-1208 2014-08-21
1639503352 Nicole Valadao Counselor 2625 F Coffee Rd # 132, Modesto, CA 95355-2053 2013-08-29
1942633979 Monika Nicole Teves Counselor 504 King Richard Ln, Modesto, CA 95350-1532 2013-08-13
1700156007 Erin L Black Counselor 426 14th St Ste 119, Modesto, CA 95354-2661 2012-01-04
1437441938 Amy Marie Lipomi Counselor 613 13th Street, Suite B, Modesto, CA 95354 2011-05-03
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Competitor

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City MODESTO
Zip Code 95350

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Dataset Information

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.

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