Shannon Buckley

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

5655 Dorothy Way
San Diego, CA 92115-2308

Phone

(415) 885-9444

NPI assigned

Aug 29, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1003429929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SANTA PAULA AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271526",
            "telephone_number": "415-885-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 DOROTHY WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921152308",
            "telephone_number": "415-885-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Donald Buckley, MD
• Maureen Dee Buckley, NP
• Paula Mary Buckley, M.F.T.
• Randy Epstein Buckley
• Robert Grant Buckley, MD
• Lindsay Bucklin, MD
• Benjamin Lester Buckman
• Natalie M Buckman
• Charlotte Buckner, PT, DPT
• Joseph Anthony Buckner, PA-C

• Athletic Trainer in San Diego, CA
• Providers in San Diego, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.