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1740409168
SHANNAN VAN HOUTEN
MODESTO, CA
NPI
1740409168
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA21438)
Enumeration Date
2007-04-24
Last Update Date
2012-11-18
Business Address
-- SHANNAN VAN HOUTEN PA
1441 FLORIDA AVE
MODESTO, CA 95350-4404
Phone number: 209-681-2870
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Mailing Address
-- SHANNAN VAN HOUTEN PA
PO BOX 575
ESCALON, CA 95320-0575
Phone number: 209-681-2870
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