Provider Demographics
NPI:1548066517
Name:PELKEY, SHAUNDRA
Entity type:Individual
Prefix:
First Name:SHAUNDRA
Middle Name:
Last Name:PELKEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 TRUMPET DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-9398
Mailing Address - Country:US
Mailing Address - Phone:530-768-7935
Mailing Address - Fax:
Practice Address - Street 1:1909 TRUMPET DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-9398
Practice Address - Country:US
Practice Address - Phone:530-768-7935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool