Provider Demographics
NPI:1023997376
Name:HERNANDEZ, SHANNON JEANINE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:JEANINE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E ROMIE LN
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4029
Mailing Address - Country:US
Mailing Address - Phone:831-757-4333
Mailing Address - Fax:
Practice Address - Street 1:450 E ROMIE LN
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4029
Practice Address - Country:US
Practice Address - Phone:831-757-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-302140174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN