SHANNON D WALLACE (NPI# 1730328840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730328840 |
| Entity Type | Individual |
| Full Name | SHANNON D WALLACE |
| Credential | BCBA |
| Practice Address |
3954 Murphy Canyon Rd Suite D105 San Diego CA 92123-4418 |
| Practice Telephone | 8585690056 |
| Practice Fax Number | 8585694233 |
| Mailing Telephone | 8585690056 |
| Mailing Fax Number | 8585694233 |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2013-03-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 1-08-4562 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AEFCT COMPANY NPI# | 1003073156 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588142574 | Shannon Wallace | Specialist | 8777 254th St, Bellerose, NY 11426-2329 | 2018-08-01 |
| 1891223293 | Shannon May Wallace | Nurse Practitioner | 700 Childrens Dr Fl Hall1, Columbus, OH 43205-2664 | 2017-05-30 |
| 1538609847 | Shannon Wallace | Behavior Technician | 841 Hughes Ln, Highlands Ranch, CO 80126-4746 | 2017-03-06 |
| 1750757340 | Shannon Wallace | Home Health Aide | 636 Candyce Ave, Lakeland, FL 33815-1202 | 2015-08-18 |
| 1205102092 | Shannon Leigh Wallace | Obstetrics & Gynecology | Cleveland Clinic 9500 Euclid Avenue, Cleveland, OH 44195-1705 | 2012-03-27 |
| 1437707452 | Shannon Wallace | Physical Therapy Assistant | 3108 Circle Dr, White Pine, TN 37890-3306 | 2019-09-03 |
| 1598103111 | Shannon R Wallace | Physician Assistant | 5818 D Harbour View Blvd, Suite 150, Suffolk, VA 23435-3327 | 2013-06-05 |
| 1326290982 | Shannon Mcnally Wallace | Social Worker | 3010 Falstaff Rd, Raleigh, NC 27610-1813 | 2008-10-15 |
| 1851481584 | Shannon L Wallace | Nurse Practitioner | 1001 W 10th St, Er/uvc, Indianapolis, IN 46202-2859 | 2006-10-13 |
| Street Address |
3954 MURPHY CANYON RD SUITE D105 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265885669 | Allison George | Behavioral Analyst | 3954 Murphy Canyon Rd, D105, San Diego, CA 92123-4418 | 2016-07-20 |
| 1902218605 | Joseph Medrano | Behavioral Analyst | 3954 Murphy Canyon Rd, Suite D105, San Diego, CA 92123-4418 | 2014-05-29 |
| 1013332097 | Joan Shin | Psychologist | 3954 Murphy Canyon Rd, San Diego, CA 92123-4418 | 2014-02-27 |
| 1639508179 | Kelly E Montiel | Behavioral Analyst | 3954 Murphy Canyon Rd, Suite D105, San Diego, CA 92123-4418 | 2013-11-05 |
| 1679814156 | Elizabeth Dewolf | Behavioral Analyst | 3954 Murphy Canyon Rd, Suite D105, San Diego, CA 92123-4418 | 2013-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766698 | Daniela Tablas | Behavioral Analyst | 303 47th St Spc D-22, San Diego, CA 92102 | 2020-09-30 |
| 1124637384 | Best Life Aba | Behavioral Analyst | 5227 Lenore Dr, San Diego, CA 92115-1639 | 2020-07-23 |
| 1992313423 | Vailala Felicia Gregory | Behavioral Analyst | 2721 Ridge View Dr, San Diego, CA 92105-4857 | 2020-07-21 |
| 1295359768 | Jake Wylie | Behavioral Analyst | 2848 Ash St, San Diego, CA 92102-1753 | 2020-06-01 |
| 1881215739 | Arasila | Behavioral Analyst | 4653 Carmel Mountain Rd Ste 308-252, San Diego, CA 92130-6650 | 2020-05-01 |
| 1255978623 | Playba | Behavioral Analyst | 4504 60th St Unit 6, San Diego, CA 92115-5470 | 2019-12-04 |
| 1689217374 | Elizabeth Gallagher | Behavioral Analyst | 1721 Grand Ave, San Diego, CA 92109-4415 | 2019-10-24 |
| 1679122568 | Carolyn Newtson | Behavioral Analyst | 9620 Chesapeake Dr Ste 205, San Diego, CA 92123-1324 | 2019-09-04 |
| 1518519933 | Communication Lab LLC | Behavioral Analyst | 4566 Pescadero Ave, San Diego, CA 92107-3537 | 2019-07-15 |
| 1538722889 | Seeds Therapy Center | Behavioral Analyst | 2707 Congress St Ste 1r, San Diego, CA 92110-2764 | 2019-04-22 |
| Find all providers in SAN DIEGO | ||||
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| 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.