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1164200705
SHANNON KELLY
OAKLAND, CA
NPI
1164200705
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-09-15
Last Update Date
2023-09-17
Business Address
SHANNON KELLY
166 SANTA CLARA AVE STE 205
OAKLAND, CA 94610-1323
Phone number: 192-951-0601
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Mailing Address
SHANNON KELLY
166 SANTA CLARA AVE STE 205
OAKLAND, CA 94610-1323
Phone number:
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