WING SHUM (NPI# 1376045724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376045724 |
Entity Type | Individual |
Full Name | WING SHUM |
Practice Address |
3626 Balboa St San Francisco CA 94121-2604 |
Practice Telephone | 4156685955 |
Mailing Telephone | 4156685955 |
Enumeration Date | 2018-03-01 |
Last Update Date | 2018-06-16 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | CA | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GREEN CARD | 089-199-843 | 01 |
Street Address |
3626 BALBOA ST |
City | SAN FRANCISCO |
State | CA |
Zip Code | 94121-2604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063591972 | Kavoos Ghanebassiri | Marriage & Family Therapist | 3626 Balboa St, San Francisco, CA 94121-2604 | 2006-11-02 |
1336751072 | Rory Pettigrew | Student in an Organized Health Care Education/Training Program | 3626 Balboa St, San Francisco, CA 94121-2604 | 2020-08-22 |
1811509631 | Lauren Glasgow | Student in an Organized Health Care Education/Training Program | 3626 Balboa St, San Francisco, CA 94121-2604 | 2020-08-21 |
1083246375 | Elena Ionov | Counselor | 3626 Balboa St, San Francisco, CA 94121-2604 | 2020-02-05 |
1740827880 | Christina Haejin Yum | Counselor | 3626 Balboa St, San Francisco, CA 94121-2604 | 2019-12-09 |
1801443486 | Mayra Hernandez | Counselor | 3626 Balboa St, San Francisco, CA 94121-2604 | 2019-08-20 |
1548817182 | Harmony Martinez | Counselor | 3626 Balboa St, San Francisco, CA 94121 | 2019-08-19 |
1972159747 | Rachael Mary Perlman | Student in an Organized Health Care Education/Training Program | 3626 Balboa St, San Francisco, CA 94121-2604 | 2019-08-16 |
1639725740 | Ridhi Shiv | Student in an Organized Health Care Education/Training Program | 3626 Balboa St, San Francisco, CA 94121-2604 | 2019-08-14 |
1356997944 | Peter Barrett Reynolds | Student in an Organized Health Care Education/Training Program | 3626 Balboa St, San Francisco, CA 94121-2604 | 2019-08-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316443815 | Joanne Mott | Community Health Worker | Richmond Area Multi Services, 3626 Balboa St., San Francisco, CA 94121 | 2018-04-03 |
1851897359 | Jeffrey Cheng | Community Health Worker | Richmond Area Multi Services 3626 Balboa St., San Francisco, CA 94121 | 2018-04-03 |
1245739283 | George Howard Herzog | Clinical Nurse Specialist | 4150 Clement St G1-111b1, San Francisco, CA 94121 | 2018-02-05 |
1063931228 | Dianna Welsh | Marriage & Family Therapist | 750 33rd Ave., San Francisco, CA 94121 | 2017-09-19 |
1144616590 | Lindsey Merrihew Haddock | Internal Medicine | 4150 Clement St Bldg 1306b, San Francisco, CA 94121 | 2015-04-13 |
1184027229 | Laura Weissberger | Social Worker | 6211 Geary Blvd, 2nd Floor, San Francisco, CA 94121 | 2014-10-03 |
1548676901 | Martha J Ignaszewski | Psychiatry & Neurology | 4150 Clement St Rm 19, San Francisco, CA 94121 | 2014-07-07 |
1912338195 | Katie Francesconi Peters | Physical Therapist | 1921 Lake St Apt 1, San Francisco, CA 94121 | 2013-12-12 |
1649601717 | William Hua | Psychologist | 4150 Clement St (116b), San Francisco, CA 94121 | 2013-11-27 |
1396182721 | Gregory Lariviere Judson | Student in an Organized Health Care Education/Training Program | 4150 Clement St. Box 111a, Vamc, San Francisco, CA 94121 | 2013-05-24 |
Find all providers in zip 94121 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750882437 | Eric Scott Verby | Peer Specialist | 3626 Balboa St, San Francisco, CA 94121-2604 | 2018-02-27 |
1356852354 | Mark James Ostergard | Peer Specialist | 1990 41st Ave, San Francisco, CA 94116-1101 | 2017-10-17 |
1710426754 | Lois Kincy | Peer Specialist | 3801 3rd St Ste 610, San Francisco, CA 94124-1446 | 2017-02-22 |
1699228825 | Cierra Norman | Peer Specialist | 1801 Vicente St, San Francisco, CA 94116-2923 | 2016-07-23 |
1568678175 | Judy L Crawford | Peer Specialist | 2500 18th St, San Francisco, CA 94110-2109 | 2007-05-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609477629 | Karen J Pompa | Peer Specialist | 2605 E Date Palm Paseo Apt 2194, Ontario, CA 91764-4670 | 2020-11-05 |
1033710231 | Marcus Kujawa | Peer Specialist | 85 Ramona Expy Ste 13, Perris, CA 92571-7014 | 2020-11-04 |
1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
1497364848 | Marissa Adrianna Garza | Peer Specialist | 1502 Verona Ct, Salinas, CA 93905-2249 | 2020-07-30 |
1235765801 | Jill Nina Bierman | Peer Specialist | 25322 Via Piedra Roja, Laguna Niguel, CA 92677-1824 | 2020-03-16 |
1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
1437783180 | Samuel Guadron Rosales | Peer Specialist | 658 E Brier Dr Ste 250, San Bernardino, CA 92408-2875 | 2020-03-02 |
1356973234 | Salina Sheoli Romero | Peer Specialist | 40 West G Street Ste. B, Los Banos, CA 93635 | 2020-02-07 |
1578103313 | Charles Winfield Eproson Jr. | Peer Specialist | 4545 Georgetown Pl Ste D, Stockton, CA 95207-6229 | 2020-01-09 |
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City | SAN FRANCISCO |
Zip Code | 94121 |
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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.