Provider Demographics
NPI:1902657869
Name:ALGEO, SHANNON M (MA, AMFT, APCC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:M
Last Name:ALGEO
Suffix:
Gender:M
Credentials:MA, AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 OJAI AVE UNIT 515
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93024-7020
Mailing Address - Country:US
Mailing Address - Phone:323-736-2007
Mailing Address - Fax:
Practice Address - Street 1:200 E DEL MAR BLVD STE 160
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2507
Practice Address - Country:US
Practice Address - Phone:310-400-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13859101YM0800X
CA139516106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health