DAVID SHANE HAGEMANN (NPI# 1881675619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881675619 |
| Entity Type | Individual |
| Full Name | DAVID SHANE HAGEMANN |
| Credential | PA |
| Practice Address |
20103 Lake Chabot Rd Castro Valley CA 94546-5341 |
| Mailing Address |
4301 Northstar Way Modesto CA 95356-9262 |
| Practice Telephone | 2093422300 |
| Practice Fax Number | 2095244240 |
| Mailing Telephone | 2093422300 |
| Mailing Fax Number | 2095244240 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2007-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SE0003X |
Clinical Nurse Specialist Specialization: Emergency |
PA147050 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | OPA147050 | 05 | |
| CA | BLUE SHIELD | OPA147050 | 01 |
| Street Address |
20103 LAKE CHABOT RD |
| City | CASTRO VALLEY |
| State | CA |
| Zip Code | 94546-5341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134122179 | Eden Medical Center | General Acute Care Hospital | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2005-05-23 |
| 1902412430 | Kenneth A Harris | Registered Nurse | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2020-09-21 |
| 1417568916 | Michael A Esparza Md Inc | Surgery | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2020-08-10 |
| 1417596289 | Linda Ann Scott-hickman | Pharmacist | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2019-12-27 |
| 1821598418 | Alyan Ali, M.d., Inc. | Internal Medicine | 20103 Lake Chabot Rd, Castro Valley, CA 94546 | 2018-02-20 |
| 1508374489 | David C Bonovich Md | Psychiatry & Neurology | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2018-01-13 |
| 1922511278 | Lisa Gaye Quan | Registered Nurse | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2017-11-08 |
| 1114439593 | David Paul Rathmann | Speech-Language Pathologist | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2017-10-25 |
| 1205378668 | Jacqueline Margolese | Nurse Practitioner | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2016-11-15 |
| 1386098309 | Travis Sunlum Lee | Internal Medicine | 20103 Lake Chabot Rd, Castro Valley, CA 94546 | 2016-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861991234 | For Your Eyes Only Ophthalmic Medical Corp. | Optometrist | 2687 Castro Valley Blvd., Castro Valley, CA 94546 | 2018-02-12 |
| 1821536954 | Webster Surgery Center, Lp | Clinic/Center | 20998 Redwood Dr, Castro Valley, CA 94546 | 2017-02-09 |
| 1639506215 | Jennifer Lee | Pharmacist | 20629 Redwood Road, Castro Valley, CA 94546 | 2013-09-27 |
| 1679860506 | Lauren Nicole Hill | Counselor | 20212 Redwood Rd Ste 104, Castro Valley, CA 94546 | 2011-06-29 |
| 1326330952 | Jeannette Villalobos | Counselor | 5248 Crane Avenue, Castro Valley, CA 94546 | 2011-05-16 |
| 1780992560 | Cherie Christine-vivona Clark | Physician Assistant | Eden Emergency Department, 20103 Lake Chabot Road, Castro Valley, CA 94546 | 2010-09-15 |
| 1518287218 | Rite Aid Incorporation | Community/Behavioral Health | 3548 Castro Valley Blv, Castro Valley, CA 94546 | 2010-06-03 |
| 1770719940 | Kristina Marie Sotto | Occupational Therapist | 20259 Lake Chabot Road, Castro Valley, CA 94546 | 2009-06-02 |
| 1861664203 | Bannanje R Nayak | Physical Medicine & Rehabilitation | 19830 Lake Chabot Road, Ste C, Castro Valley, CA 94546 | 2008-03-26 |
| 1205030202 | Yvonne Marie Jones | Social Worker | 2055 Fairmont Dr., San Leandro, CA 94546 | 2007-06-13 |
| Find all providers in zip 94546 | ||||
| Taxonomy Code | 364SE0003X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Emergency |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194262113 | Jennifer Glidden | Clinical Nurse Specialist | 10336 Wilshire Blvd, 602, Los Angeles, CA 90024-4730 | 2017-01-28 |
| 1134188501 | Joshua Salome Inez Luftig | Clinical Nurse Specialist | 1411 East 31 Street, Oakland, CA 94602-1018 | 2006-03-22 |
| 1508832965 | Hilda A Villarreal | Clinical Nurse Specialist | 1209 Woodrow Ave, Modesto, CA 95350-1288 | 2006-02-27 |
| 1205347309 | Julie A Rossie | Clinical Nurse Specialist | 700 Lawrence Expy, Santa Clara, CA 95051-5173 | 2017-10-16 |
| 1487017919 | Candice Castro Medina | Clinical Nurse Specialist | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2016-04-01 |
| 1548353329 | Harold Edward Baker Ix | Clinical Nurse Specialist | 825 Delbon Avenue, Turlock, CA 95380-2016 | 2006-10-02 |
| 1215986732 | Brandon Lee Shulman | Clinical Nurse Specialist | 1411 East 31st Street, Oakland, CA 94602-1018 | 2006-05-10 |
| 1003887480 | Patricia Scott Meyer | Clinical Nurse Specialist | 1411 E 31st St, Oakland, CA 94602-1018 | 2006-02-01 |
| 1457331373 | Linda J Shipp | Clinical Nurse Specialist | 825 Delbon Ave, Turlock, CA 95380-2016 | 2006-01-18 |
| 1962482877 | Shane Andrew Tipton | Clinical Nurse Specialist | 1000 Greenley Rd, Sonora, CA 95370-5200 | 2006-01-18 |
| Find all providers with the same taxonomy | ||||
| City | CASTRO VALLEY |
| Zip Code | 94546 |
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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.