Individual provider · Type 1 NPI
Shannon Sullivan, RN
Prescribing (Medical) Psychologist · Tracy, CA
Practice location
20 E Eaton Ave
Tracy, CA 95376-3100
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prescribing (Medical) Psychologist Primary | 103TP0016X | None listed |
| Registered Nurse | 163W00000X | 789456 (IA) |
Prescribing (Medical) Psychologist: A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or…
About NPI 1922574920
Shannon Sullivan, RN's National Provider Identifier is 1922574920, issued on Oct 17, 2018. The primary taxonomy on file is Prescribing (Medical) Psychologist (103TP0016X), and the practice location is in Tracy, CA. The record was last updated on May 3, 2025.