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

Individual provider Physician Assistant · NPI 1902961626

Shannon L Cornwell, PA is a Mental Health Counselor in Fullerton, California. Qualified in 2002, 24 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
24
Licensed in
CA
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

101 E Valencia Mesa Dr Em Dept
Fullerton, CA 92835-3809
Phone: (714) 992-3965
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA17022 (CA)

Record details

NPI number1902961626
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedDecember 22, 2006
Last updated in NPPESMarch 11, 2009

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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