NPI Code Detail JSON Logo

1891511473 NPI number — SHANNAN MARIE PAUL

NPI Number: 1891511473
Health Care Provider/Practitioner: SHANNAN MARIE PAUL

Information about “1891511473” NPI (SHANNAN MARIE PAUL) exists in 1891511473 in HTML format HTML  |  1891511473 in plain Text format TXT  |  1891511473 in PDF (Portable Document Format) PDF  |  1891511473 in an XML format XML  formats.

NPI Number : 1891511473 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891511473",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PAUL",
    "FirstName": "SHANNAN",
    "MiddleName": "MARIE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7224 S RECOVERY RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FRENCH CAMP",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95231-8901",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "209-888-6595",
    "MailingAddressFaxNumber": "209-888-6596",
    "FirstLinePracticeLocationAddress": "7224 S RECOVERY RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FRENCH CAMP",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95231-8901",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "209-888-6595",
    "PracticeLocationAddressFaxNumber": "209-888-6596",
    "EnumerationDate": "11/27/2024",
    "LastUpdateDate": "03/21/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "172V00000X",
          "TaxonomyName": "Community Health Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "373H00000X",
          "TaxonomyName": "Day Training/Habilitation Specialist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.