Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon Bagnasco

Individual provider Family Nurse Practitioner · NPI 1235554510

Shannon Bagnasco is a Nurse Practitioner in Menifee, California. Qualified in 2014, 12 years ago. Practices with Elizabeth Supportive Medical Specialists a Medical Corporation, an 8-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2014
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Practice location Address checks out

26926 Cherry Hills Blvd Ste B
Menifee, CA 92586-2500
Phone: (951) 216-2200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95000377 (CA)

Record details

NPI number1235554510
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 24, 2014
Last updated in NPPESFebruary 24, 2014
Mailing address425 N Date St, Escondido, CA 92025-3413

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Elizabeth Supportive Medical Specialists A Medical Corporation — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Menifee