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SHANNON ABERNATHY
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1033427125
Individual Registrant: SHANNON ABERNATHY
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
115C CORAL ST SANTA CRUZ, CA 95060-2148 US
Tel: 831-459-6644 Fax: --
Tel: 831-459-6644 Fax: --
Contact information for business:
290 PIONEER ST SANTA CRUZ, CA 95060-2133 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1033427125
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| RSS/CSOP PROVIDER IDENTIFIER NUMBER | 44P | 01 |
