Healthcare Provider Details

I. General information

NPI: 1659280048
Provider Name (Legal Business Name): SHAWNA PATRICIA PARKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16150 PLACER ST
JAMESTOWN CA
95327-9502
US

IV. Provider business mailing address

16150 PLACER ST
JAMESTOWN CA
95327-9502
US

V. Phone/Fax

Practice location:
  • Phone: 209-728-7770
  • Fax:
Mailing address:
  • Phone: 209-728-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: