SHANNON BENNETT-GUNDERSON NPI 1073054334

NPI Information

  • NPI: 1073054334
  • Provider Name: SHANNON BENNETT-GUNDERSON
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 5717 PACIFIC CENTER BLVD STE 200
    SAN DIEGO, CA
    ZIP 92121
  • Phone: (858) 859-1188

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NPI Details

Shannon Bennett-gunderson is a family nurse practitioner in San Diego, CA. Shannon Bennett-gunderson NPI is 1073054334. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5717 PACIFIC CENTER BLVD STE 200
SAN DIEGO, CA
ZIP 92121-250
Phone: (858) 859-1188

The enumeration date for this NPI number is 3/19/2017 and was last updated on 5/10/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily536000CALIFORNIANo
2363LF0000XNurse PractitionerFamily95005012CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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