Shavannah Te'hera Wilson, is a
Social Worker - Clinical based in Long Beach, California. Shavannah Te'hera Wilson is licensed to practice in California (license number 110321) and her current practice location is
5150 E Pacific Coast Hwy Ste 100, Long Beach, California. She can be reached at her office (for appointments etc.) via phone at
(562) 490-7600.
NPI number for Shavannah Te'hera Wilson is 1295307098 and her current mailing address is 5150 E Pacific Coast Hwy Ste 100, Long Beach, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1295307098.
Healthcare Provider's Profile
Full Name | Shavannah Te'hera Wilson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 5150 E Pacific Coast Hwy Ste 100, Long Beach, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1295307098
- Provider Enumeration Date: 07/12/2021
- Last Update Date: 06/23/2023
Medical Identifiers
Medical identifiers for Shavannah Te'hera Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295307098 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 110321 (California) | Secondary |
1041C0700X | Social Worker - Clinical | 110321 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shavannah Te'hera Wilson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shavannah Te'hera Wilson, 5150 E Pacific Coast Hwy Ste 100, Long Beach, CA 90804-3394 Ph: (562) 490-7600 | Shavannah Te'hera Wilson, 5150 E Pacific Coast Hwy Ste 100, Long Beach, CA 90804-3394 Ph: (562) 490-7600 |
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