Shannon Mullen, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1690 Barton Rd
Redlands, CA 92373-4229

Phone

(909) 793-3311

NPI assigned

Sep 5, 2015

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beaver Medical Group P C

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1649503319
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment
• Beaver Medical Group P C

  • Physical Therapist
  • Redlands, CA
  • NPI 1427090281
  NPD
• Beaver Medical Group P C

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1275570830
  NPD (past)
• Diagnostic Imaging Services

  • Magnetic Resonance Imaging (MRI) Internal Medicine Physician
  • Metairie, LA
  • NPI 1699793166
  NPD (past)

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

{
    "created_epoch": "1441411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1992173017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 BARTON RD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734229",
            "telephone_number": "909-793-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "SHANNON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-05",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Movement Recentered Physical Therapy
• Katelyn Moyer, DMD
• Aaron James Mozqueda
• Kayli Muir
• Nikki Lynn Muise
• Jessica Muller
• Tiffany Munguia
• Alexis Dominique Munoz
• Ariana Munoz, PHARMD
• Aurelio R Munoz Jr.

• Medical Physician Assistant in Redlands, CA
• Providers in Redlands, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.