SHANNON COFFARO – Clinical Social Worker, NPI 1699409755

SHANNON COFFARO is a healthcare provider. based in Lodi, California. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 100968 (CA). The NPI Number for SHANNON COFFARO is 1699409755

Main info

Female
19 Years Of Experience
Name
SHANNON COFFARO
NPI
1699409755
Phone
(209) 608-5622
Address
2259 S HAM LN
Enumeration Date
14 July 2022
Last Update Date
18 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5033255722268
Graduation Year
2007 (19 years ago)
PAC ID
8921595380
Group Practice PAC ID
1355336454
Professional Enrollment ID
I20251017002484
Address ID
OR971036009AS115XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

4,987 CLINICAL SOCIAL WORKER in CA

Provider Addresses for SHANNON COFFARO

  • 2259 S HAM LN

    LODI, CA 952424544

    Phone: (209) 608-5622

    Type: Mailing

  • 7000 MICHAEL CANLIS WAY

    FRENCH CAMP, CA 952319781

    Phone: (209) 468-4550

    Type: Location

  • 65 N HIGHWAY 101 STE 204

    WARRENTON, OR 971469371

    Phone: (503) 325-5722

    Type: Mailing

  • 1005 BROADWAY ST

    SEASIDE, OR 971387845

    Phone: (503) 325-5722

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251017002484IClinical Social WorkerORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95242)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355336454View full group profile
NameSpecialtyState
Clinical Social WorkerOR
Clinical Social WorkerOR
Clinical Social WorkerOR
-OR
Mental Health CounselorOR
Mental Health CounselorOR
Clinical Social WorkerOR
-WA

Reviews

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Frequently asked questions

What identifier follows SHANNON COFFARO across health systems?
The NPI 1699409755 uniquely identifies SHANNON COFFARO in U.S. healthcare data.
Quick check: is SHANNON COFFARO active?
Public NPPES data shows SHANNON COFFARO with an active NPI status right now.
Which specialty label fits SHANNON COFFARO?
NPPES ties SHANNON COFFARO to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SHANNON COFFARO?
SHANNON COFFARO is associated with Lodi, California in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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