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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104517119

Shannon Stallone is a Student in an Organized Health Care Education/Training Program in San Rafael, California. Registered with an NPI since 2023.

In the registry since
2023
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Practice location Address checks out

1330 Lincoln Ave Ste 201
San Rafael, CA 94901-2142
Phone: (415) 459-5999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1104517119
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 19, 2023
Last updated in NPPESMay 19, 2023
Certification dateMay 19, 2023
Mailing address1 Pueblo Dr, San Rafael, CA 94903-1523

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