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Individual

SHANNON DEE DONEGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2490 HOSPITAL DR STE 111, MOUNTAIN VIEW, CA 94040-4126
(650) 934-7530
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA.0007622
CO
363AS0400X
Surgical Physician Assistant
PA.0007622
CO
363AS0400X
Surgical Physician Assistant
Primary
PA57225
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2088082
WA
05
500733841
OR
Enumeration date
09/25/2017
Last updated
03/10/2023
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