Provider Demographics
NPI:1124587209
Name:MASAMITSU, SHANNON KATHLEEN (BCBA)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:KATHLEEN
Last Name:MASAMITSU
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:KATHLEEN
Other - Last Name:HASQUET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:855 N DOBSON RD APT 2007
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6969
Mailing Address - Country:US
Mailing Address - Phone:661-505-3784
Mailing Address - Fax:
Practice Address - Street 1:2725 S ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-4403
Practice Address - Country:US
Practice Address - Phone:480-716-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician