JIEUN SHIN (NPI# 1275035917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275035917 |
Entity Type | Individual |
Full Name | JIEUN SHIN |
Practice Address |
12828 Harbor Blvd Ste 320 Garden Grove CA 92840-5834 |
Mailing Address |
12842 Palm St Ph 4 Garden Grove CA 92840-6427 |
Practice Telephone | 7146363032 |
Enumeration Date | 2018-03-07 |
Last Update Date | 2018-03-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
NP95008532 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
12828 HARBOR BLVD STE 320 |
City | GARDEN GROVE |
State | CA |
Zip Code | 92840-5834 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255846226 | Providence Foot and Ankle Center | Podiatrist | 12828 Harbor Blvd Ste 320, Garden Grove, CA 92840-5834 | 2017-12-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
Find all providers in zip 92840 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
1770830499 | Christina Duong | Nurse Practitioner | 7761 Garden Grove Blvd, Garden Grove, CA 92841-4200 | 2012-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235738782 | Peninsula Healthcare Center | Nurse Practitioner | 22330 Hawthorne Blvd Ste 208, Torrance, CA 90505-2536 | 2020-10-25 |
1710584008 | Venessa Beck | Nurse Practitioner | 903 Cardiff St, San Diego, CA 92114-5019 | 2020-10-08 |
1053918094 | Janel Nicole Sanglerat | Nurse Practitioner | 416 Aviation Blvd, Santa Rosa, CA 95403-1032 | 2020-10-02 |
1790382760 | Christopher Tran | Nurse Practitioner | 11441 Heacock St Ste F, Moreno Valley, CA 92557-7907 | 2020-10-02 |
1487266292 | Mollie Shira Hudson | Nurse Practitioner | 14 Whitmore Pl Apt 15, Oakland, CA 94611-4635 | 2020-08-21 |
1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
1952912131 | Norman Ivan Kier | Nurse Practitioner | 3834 Edison Ave, Sacramento, CA 95821-2728 | 2020-08-12 |
1942811377 | Thanhan Mathews | Nurse Practitioner | 114 W Cameron St Apt B, Hanford, CA 93230-2965 | 2020-08-10 |
1972113355 | Marine Mary Kademyan | Nurse Practitioner | 6528 Babcock Ave, North Hollywood, CA 91606 | 2020-07-31 |
1245849645 | Shannon Pereira | Nurse Practitioner | 2368 Honeysuckle Way, Hemet, CA 92545-4796 | 2020-07-31 |
Find all providers with the same taxonomy |
City | GARDEN GROVE |
Zip Code | 92840 |
Please comment or provide details below to improve the information on JIEUN SHIN.
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.