Individual
SHANNON NATHAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1131 SAN FELIPE RD, HOLLISTER, CA 95023-2800
(831) 636-4020
(831) 636-4025
Mailing address
1131 SAN FELIPE RD, HOLLISTER, CA 95023-2800
(831) 636-4020
(831) 636-4025
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
723307
CA
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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