Provider Demographics
NPI:1053400978
Name:MARIONI, SHAUNA II (MSN, NP, CNM)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:MARIONI
Suffix:II
Gender:F
Credentials:MSN, NP, CNM
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:
Other - Last Name:MARIONI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, NP, CNM
Mailing Address - Street 1:3700 VACA VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9430
Mailing Address - Country:US
Mailing Address - Phone:707-453-5462
Mailing Address - Fax:
Practice Address - Street 1:3700 VACAVALLEY PKWY
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-9543
Practice Address - Country:US
Practice Address - Phone:707-453-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP11072363LW0102X
CA1407367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife