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

Shannon Ly

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1235848268

Shannon Ly is a Student in an Organized Health Care Education/Training Program in Fullerton, California. Licensed in California. Registered with an NPI since 2022.

Licensed in
CA
In the registry since
2022
Specialties on file
2

Practice location Address checks out

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone: (714) 651-8138
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA61877 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1235848268
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 17, 2022
Last updated in NPPESFebruary 5, 2023
Certification dateFebruary 5, 2023
Mailing addressPo Box 505, Temple City, CA 91780-0505

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