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SHANNON MARIE BADER PHD

Clinical >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1316266281

Individual Registrant:
 SHANNON MARIE BADER PHD
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

Contact information for business:
1600 9TH ST STE 205  SACRAMENTO, CA 95814-6435 US
Tel: 916-654-2431  Fax: 916-654-3186

Registration Information:
NPI: 1316266281
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
Clinical
CAPSY 22905

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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