AUDRIANNA SHAUNTERA SMITH (NPI# 1124650155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124650155 |
| Entity Type | Individual |
| Full Name | AUDRIANNA SHAUNTERA SMITH |
| Credential | NP |
| Practice Address |
415 E Harding Way Ste D Stockton CA 95204-6118 |
| Practice Telephone | 2099445750 |
| Practice Fax Number | 2094642684 |
| Mailing Telephone | 2099445750 |
| Mailing Fax Number | 2094642684 |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
95013033 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
415 E HARDING WAY STE D |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-6118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972074821 | Usha R Vyas | Nurse Practitioner | 415 E Harding Way Ste D, Stockton, CA 95204-6118 | 2018-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| Find all providers in zip 95204 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982010740 | Natalia Semyenova I | Nurse Practitioner | 5251 Barber Rd, Stockton, NY 14784-9738 | 2014-07-01 |
| 1821160235 | Sandra K Wells | Nurse Practitioner | 2626 N California St Ste B, Stockton, CA 95204-5500 | 2006-11-14 |
| 1598292021 | Judy Lynn Crouch | Nurse Practitioner | 1800 N California St, Stockton, CA 95204-6019 | 2017-05-15 |
| 1710432802 | Hoaitram Dinh | Nurse Practitioner | 7373 West Ln, Stockton, CA 95210-3377 | 2016-08-18 |
| 1942589965 | Donna J Burke | Nurse Practitioner | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2011-08-08 |
| 1427250554 | Donna Lynn Lebaron | Nurse Practitioner | 1041 Brookside Rd, Stockton, CA 95211-0001 | 2007-06-01 |
| 1780795021 | Claudia Beth Fagilde | Nurse Practitioner | 678 N Wilson Way, Stockton, CA 95205-4272 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388504 | Daniel Ngo | Nurse Practitioner | 1180 S Hilda St, Anaheim, CA 92806-5007 | 2020-08-28 |
| 1407464522 | Laura Bradigan | Nurse Practitioner | 1744 Grand Ave Unit 2, Long Beach, CA 90804-2022 | 2020-07-15 |
| 1538787031 | Kelly Olcott | Nurse Practitioner | 4004 Via Lucero Apt 12, Santa Barbara, CA 93110-1692 | 2020-07-10 |
| 1629695440 | Kelley Ibarra | Nurse Practitioner | 1613 Celeste Dr, Modesto, CA 95355-5039 | 2020-06-26 |
| 1497379333 | Gloria Jean Campbell | Nurse Practitioner | 5055 E Garford St Apt 6, Long Beach, CA 90815-2861 | 2020-06-06 |
| 1851913115 | Lilly Fong | Nurse Practitioner | 15821 Square Top Ln, Fontana, CA 92336-4586 | 2020-05-09 |
| 1548880750 | Sharkeiya Terrell | Nurse Practitioner | 2752 Harrison Ave Ste A, Eureka, CA 95501-4738 | 2020-04-17 |
| 1730714007 | Julissa Leonides Caraballo | Nurse Practitioner | 4044 Promontory St, San Diego, CA 92109-5334 | 2020-03-07 |
| 1194355404 | Bethany Leda Donowho | Nurse Practitioner | 845 Via De La Paz Ste 16, Pacific Palisades, CA 90272-3627 | 2020-01-26 |
| 1518507078 | Rachel Saake Collar | Nurse Practitioner | 5100, 1000 Executive Pkwy, Oroville, CA 95966 | 2020-01-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.