Individual
SHANNON ILENE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPEC.
Contact information
Practice address
12501 IMPERIAL HWY STE 500B, NORWALK, CA 90650-3179
(562) 864-7821
Mailing address
12501 IMPERIAL HWY STE 500B, NORWALK, CA 90650-3179
(562) 864-7821
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-AIZKLM
CA
Other
Enumeration date
06/30/2025
Last updated
09/15/2025
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