Individual
MRS. SHANNON LEIGH WEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
6605 NANCY RIDGE DR STE A, SAN DIEGO, CA 92121-2253
(858) 900-2747
(858) 750-2984
Mailing address
6605 NANCY RIDGE DR STE A, SAN DIEGO, CA 92121-2253
(858) 900-2747
(858) 750-2984
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
19346
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1057171
NCCPA CERTIFICATION
—
01
—
PA03551
STATE LICENSE
TX
01
—
PA19346
STATE LICENSE
CA
Enumeration date
12/14/2007
Last updated
10/20/2024
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