Provider Demographics
NPI:1699108712
Name:COTTIER, SHANNON ROCHELLE (BA)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:ROCHELLE
Last Name:COTTIER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5036 SUNREY RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:530-644-2412
Mailing Address - Fax:530-644-0927
Practice Address - Street 1:5036 SUNREY RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667
Practice Address - Country:US
Practice Address - Phone:530-644-2412
Practice Address - Fax:530-644-0927
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health