ATHERINE DANICE SHACKELFORD (NPI# 1245732858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245732858 |
Entity Type | Individual |
Full Name | ATHERINE DANICE SHACKELFORD |
Credential | LVN,RN |
Practice Address |
909 Pico Blvd Santa Monica CA 90405-1326 |
Practice Telephone | 3103146200 |
Mailing Telephone | 3103146200 |
Enumeration Date | 2018-02-28 |
Last Update Date | 2018-02-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
95152474 | CA | Nursing Service Providers |
Street Address |
909 PICO BLVD |
City | SANTA MONICA |
State | CA |
Zip Code | 90405-1326 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639299407 | Katheryn Leanne Whittaker | Counselor | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2007-03-29 |
1508472887 | Tracy Gage | Licensed Vocational Nurse | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2020-09-22 |
1366083396 | Stephen Richard Ball | Counselor | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2019-10-01 |
1679127799 | Lavert S Porter | Counselor | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2019-07-26 |
1699237503 | Christopher Johnson | Counselor | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2019-04-01 |
1982174348 | Kenneth Noel | Licensed Vocational Nurse | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2018-11-28 |
1750859534 | Paulina Dianne Speaker | Counselor | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2018-11-09 |
1821565250 | Brandon Lejuan Smith | Counselor | 909 Pico Blvd, Santa Monica, CA 90404 | 2018-10-24 |
1295219467 | Demetria Mccalla | Contractor | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2018-09-24 |
1609355155 | Luis Jesus Maldonado | Counselor | 909 Pico Blvd, Santa Monica, CA 90405-1326 | 2018-08-07 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699328476 | Nicole Ryan Harbeck | Marriage & Family Therapist | 2716 Ocean Park Blvd Ste 2007, Santa Monica, CA 90405 | 2019-07-19 |
1922664440 | Betty Ann Wise | Counselor | 1865 W. 9th Street, Santa Monica, CA 90405 | 2019-05-10 |
1790203776 | Ernest Jones Jr. | Counselor | 909 Pico Blvd., Santa Monica, CA 90405 | 2017-08-30 |
1285171371 | Jori Adler Marriage & Family Therapy Prof. Corp. | Marriage & Family Therapist | 3400 Airport Ave Ste 30, Santa Monica, CA 90405 | 2017-01-26 |
1376993147 | Damoan Corp. | Speech-Language Pathologist | 2801 Ocean Park Blvd Ste 393, Santa Monica, CA 90405 | 2016-06-13 |
1427410034 | Adam Rubio | Clinical Neuropsychologist | 1916 4th Street, Santa Monica, CA 90405 | 2016-03-23 |
1760852842 | Yramnna Smith | Behavioral Analyst | 2716 Ocean Park Blvd Ste 1025, Santa Monica, CA 90405 | 2015-10-01 |
1689086076 | Cheryl K. Baker | Community Health Worker | 1750 Ocean Park Blvd., Suite 206, Santa Monica, CA 90405 | 2014-05-20 |
1629409891 | Dominique M. Delvecchio | Nurse Practitioner | 2716 Ocean Park Blvd. Suite 3082, Institute for Nerve Medicine, Santa Monica, CA 90405 | 2013-12-12 |
1639512692 | Nancy Elizabeth Hyland | Marriage & Family Therapist | 1720 Ocean Park Blvd, Suite 200a, Santa Monica, CA 90405 | 2013-04-09 |
Find all providers in zip 90405 |
Taxonomy Code | 163WM0705X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Medical-Surgical |
Definition to come... |
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1902405285 | Njambi Neri Muiru | Registered Nurse | 1800 Willow Springs Ave, Coalinga, CA 93210-9267 | 2020-10-19 |
1073110334 | Rosemary Mwelu Maingi | Registered Nurse | 24222 Dandelion Ct, Lake Elsinore, CA 92532-2741 | 2020-10-08 |
1083221840 | Bing Rounsavall | Registered Nurse | 645 Adams St Apt 3, Davis, CA 95616-3277 | 2020-09-25 |
1952916660 | Kelly Straight | Registered Nurse | 300 Pasteur Dr Unit C2, Stanford, CA 94305-2200 | 2020-09-10 |
1487268264 | Stefan Chan | Registered Nurse | 1969 Bonifacio St Apt 4, Concord, CA 94520-2260 | 2020-08-31 |
1609488519 | Corina Elizabeth Ceron | Registered Nurse | 9895 Devon St, Rancho Cucamonga, CA 91730-3613 | 2020-08-21 |
1417567579 | Domiano Mutuku Mussau | Registered Nurse | 806 American Ave, Lemoore, CA 93245-9166 | 2020-08-04 |
1386252518 | Regina Muriithi Njoroge | Registered Nurse | 11702 Parliament Dr, Rancho Cucamonga, CA 91730-8231 | 2020-07-14 |
1487275467 | Yelena Razgonyayeva | Registered Nurse | 10330 Sophia Ave, Granada Hills, CA 91344-6845 | 2020-05-01 |
1134748247 | Sonja Wood | Registered Nurse | 92691 Avenida Deseo, Mission Viejo, CA 92691 | 2020-04-09 |
Find all providers with the same taxonomy |
City | SANTA MONICA |
Zip Code | 90405 |
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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.