SHANNON BLACK (NPI# 1528590031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528590031 |
| Entity Type | Individual |
| Full Name | SHANNON BLACK |
| Credential | MS, CF-SLP |
| Practice Address |
60 Daggett Dr San Jose CA 95134-2108 |
| Practice Telephone | 4084342277 |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | RPE10752 | CA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528448271 | Shannon Trice Black | Counselor | 1900 Manakin Rd Ste G, Manakin Sabot, VA 23103-2252 | 2015-06-08 |
| 1134413438 | Shannon Nichole Black | Chiropractor | 3803 Palmer Park Blvd, Suite B, Colorado Springs, CO 80909-2600 | 2011-06-03 |
| 1679595300 | Shannon L Black | Psychologist | 6120 Havelock Ave, Suite B, Lincoln, NE 68507-1278 | 2006-07-24 |
| 1063948248 | Shannon Black | Developmental Therapist | 550 N Reo St, Tampa, FL 33609-1061 | 2017-05-07 |
| 1649668567 | Shannon Elizabeth Black | Counselor | 1921 Ransom Pl, Nashville, TN 37217-3841 | 2014-12-30 |
| 1629184213 | Shannon Black | Physical Therapist | 4100 Lake Otis Pkwy, Ste 106, Anchorage, AK 99508-5222 | 2006-08-23 |
| Street Address |
60 DAGGETT DR |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95134-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588913131 | Services for Brain Injury | Day Training, Developmentally Disabled Services | 60 Daggett Dr, San Jose, CA 95134-2108 | 2012-08-29 |
| 1427581974 | Maria Sedillo-glatt | Day Training, Developmentally Disabled Services | 60 Daggett Dr, San Jose, CA 95134-2108 | 2017-04-11 |
| 1164873402 | Kiiya Shibata | Speech-Language Pathologist | 60 Daggett Dr, San Jose, CA 95134-2108 | 2016-06-28 |
| 1669826491 | Michelle Urquidez | Occupational Therapist | 60 Daggett Dr, San Jose, CA 95134-2108 | 2016-04-18 |
| 1942692637 | Michelle Lee | Physical Therapist | 60 Daggett Dr, San Jose, CA 95134-2108 | 2015-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013433945 | Jessica Roberson | Speech-Language Pathologist | 330 Crescent Village Circle, San Jose, CA 95134 | 2017-08-22 |
| 1407221948 | Bay Area Behavioral Group | Community/Behavioral Health | 4423 Fortran Court, #136, San Jose, CA 95134 | 2015-12-09 |
| 1891114500 | Adriane Jones | Occupational Therapist | 640 Epic Way, Apartment #271, San Jose, CA 95134 | 2014-04-09 |
| 1255758165 | Adam Moreno | Counselor | 2625 Zanker Rd., San Jose, CA 95134 | 2014-03-28 |
| 1972938801 | Claudine Lott | Family Medicine | 145 Nicholson Ln, San Jose, CA 95134 | 2013-09-11 |
| 1659611556 | 360 Degree Customer Inc | Early Intervention Provider Agency | 4423 Fortran Drive, # 114, San Jose, CA 95134 | 2013-03-01 |
| 1629392022 | Harrison James Kornfield | Surgery | 455 Navaro Way, #108, San Jose, CA 95134 | 2010-03-15 |
| 1538348008 | Roxanne F Ubana | Counselor | 4423 Fortran Ct Ste 136, San Jose, CA 95134 | 2007-10-31 |
| 1538351044 | William Lopez Robles | Counselor | 2625 Zanker Road, San Jose, CA 95134 | 2007-08-17 |
| 1881717296 | Chloe Chu | Dentist | 3720 N. First Street, Suite C, San Jose, CA 95134 | 2007-04-09 |
| Find all providers in zip 95134 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536206 | Marissa Burton | Student in an Organized Health Care Education/Training Program | 1759 Queenstown Dr, San Jose, CA 95132-1755 | 2020-10-21 |
| 1891394987 | Shannon Shen | Student in an Organized Health Care Education/Training Program | 190 Ryland St Apt 3422, San Jose, CA 95110-2295 | 2020-10-20 |
| 1750992152 | Jolene Thu Tran | Student in an Organized Health Care Education/Training Program | 2811 Glauser Dr, San Jose, CA 95133-1410 | 2020-08-11 |
| 1588273270 | Kimberly Ngoc Nguyen | Student in an Organized Health Care Education/Training Program | 3094 Seafield Ct, San Jose, CA 95148-4044 | 2020-07-28 |
| 1699393884 | Nancy Tang | Student in an Organized Health Care Education/Training Program | 3130 Brightwood Ct, San Jose, CA 95148-2649 | 2020-07-14 |
| 1548884125 | Chelsea Lorraine Barnes | Student in an Organized Health Care Education/Training Program | 1045 Lincoln Ct, San Jose, CA 95125-2638 | 2020-05-30 |
| 1891318705 | Magdalena Cachu-enciso | Student in an Organized Health Care Education/Training Program | 1624 June Ave, San Jose, CA 95122-2211 | 2020-05-26 |
| 1104448729 | Veerali Juthani | Student in an Organized Health Care Education/Training Program | 3920 Braeburn Ct, San Jose, CA 95130-1206 | 2020-05-18 |
| 1811518020 | Thomas Vo | Student in an Organized Health Care Education/Training Program | 3205 San Rivas Dr, San Jose, CA 95148-2037 | 2020-04-28 |
| 1831727130 | Brent Carmona | Student in an Organized Health Care Education/Training Program | 3791 Heppner Ln, San Jose, CA 95136-1506 | 2020-03-31 |
| Find all providers in SAN JOSE | ||||
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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.