Individual
DR. SHANNON MONG
Active
Individual
DR. SHANNON MONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20722
CA
103TC0700X
Clinical Psychologist
3803
OR
103TC2200X
Clinical Child & Adolescent Psychologist
20722
CA
103TC2200X
Clinical Child & Adolescent Psychologist
3803
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY20722
PSYCHOLOGIST LICENSE
CA
01
—
PSY3803
PSYCHOLOGIST LICENSE
OR
Enumeration date
07/20/2006
Last updated
07/24/2025
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