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General NPI Number Information
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NPI Number | 1710288931
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Entity Type | Organization
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Legal Business Name | SHIMAREE FOSTER
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 10/23/2011
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Provider Practice Location Address
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Address Line | 3766 NYE AVE
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City | RIVERSIDE
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State | CA
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Zip | 92505-1867
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Country | US
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Telephone | 951-689-2340
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 494
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City | RIVERSIDE
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State | CA
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Zip | 92502-0494
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RN/TREAMENT NURSE/SUPERVISOR
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Name | SHIMAREE FOSTER
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Credential |
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Telephone | 951-689-2340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | VN231776
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License Number State | CA
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