Individual
DANIELLE TERESE SHANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 DOLORES AVE, SAN LEANDRO, CA 94577-5007
(510) 984-2489
(510) 788-6830
Mailing address
201 DOLORES AVE, SAN LEANDRO, CA 94577-5007
(510) 984-2489
(510) 788-6830
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
59456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59456
PA-C LICENSE
CA
Enumeration date
12/06/2020
Last updated
12/16/2025
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