Shannon Marie Anderson, RN
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Eureka, CA
NPI 1295538882 · NPPES record last updated Apr 4, 2025
Key facts
- NPI
- 1295538882
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- 95392615 (CA)
- Practice address
- 720 Wood St
Eureka, CA 95501-4413 - Phone
- (707) 268-2990
- NPI assigned
- Mar 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95392615 | CA | MD | Psychiatric/Mental Health Registered Nurse |
| 1698886 | CO | MD | Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 1698886 | CO | |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 95392615 | CA | Yes |
Addresses
Primary practice location
720 Wood St
Eureka, CA 95501-4413
Mailing address
12588 W Dakota Ave Apt 203
Lakewood, CO 80228-2533
Phone (417) 763-8683
Other providers in Eureka, CA
- John Raymond Anderson
- Kristen Leigh Anderson
- R'Delle Marie Anderson
- Sara Anderson
- Sean Garrett Anderson
- Sienna Anderson
- Zachary Anderson
- Andrew Scott Greer, PHD
- William Andrews
- Delaney Andrus
All providers in Eureka, CA · Psychiatric/Mental Health Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.