Individual
SHANNON BELLANCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
2701 MIDWAY DR UNIT 371141, SAN DIEGO, CA 92137-6110
(724) 974-9932
Mailing address
851 BOWSPRIT RD, CHULA VISTA, CA 91914-4529
(213) 915-8277
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/12/2019
Last updated
06/18/2021
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