Individual
SHANNON M BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
TELEHEALTH FROM HOME, 1857 BROOKHURST ST, MEDFORD, OR 97504
(458) 206-4784
Mailing address
303 TWIN DOLPHIN DRIVE, SUITE 600-6002, REDWOOD CITY, CA 94065
(844) 542-5481
(877) 237-0105
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
ASW70857
CA
1041C0700X
Clinical Social Worker
93649
CA
1041C0700X
Clinical Social Worker
Primary
L12986
OR
Other
Enumeration date
01/18/2019
Last updated
05/20/2024
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