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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