Individual
MRS. SHANNON MARIE GOULMASSIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNS
Contact information
Practice address
1725 WESTERN AVE, SAN BERNARDINO, CA 92411-1367
(909) 887-6333
Mailing address
PO BOX 10967, SAN BERNARDINO, CA 92423-0967
(909) 796-2036
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
536211
CA
163WL0100X
Lactation Consultant (Registered Nurse)
L-17087
CA
364SP1700X
Perinatal Clinical Nurse Specialist
Primary
1382
CA
Other
Enumeration date
11/28/2011
Last updated
03/18/2024
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