Individual
SHANNON HEUKLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, MPH, AGPCNP-BC
Contact information
Practice address
1930 MARKET ST, SAN FRANCISCO, CA 94102-6228
(415) 476-3902
Mailing address
1930 MARKET ST, SAN FRANCISCO, CA 94102-6228
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
95003581
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95003581
CA
Other
Enumeration date
01/04/2016
Last updated
04/08/2026
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