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SHANNON MARIE BADER PHD
Clinical >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1316266281
Individual Registrant: SHANNON MARIE BADER PHD
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
3102 E HIGHLAND AVE PATTON, CA 92369-7813 US
Tel: 909-425-7552 Fax: 909-425-6407
Tel: 909-425-7552 Fax: 909-425-6407
Contact information for business:
1600 9TH ST STE 205 SACRAMENTO, CA 95814-6435 US
Tel: 916-654-2431 Fax: 916-654-3186
Tel: 916-654-2431 Fax: 916-654-3186
Registration Information:
NPI: 1316266281
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist Clinical | CA | PSY 22905 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
