Active NPI
Shannon Etier
- Prosthetics Case Management
- Oakland, CA
National Provider Identifier
1033539960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 465422495
- Practice address
- 248 3Rd St # 551
Oakland, CA 94607-4375 - Phone
- (510) 205-6707
- NPI assigned
- Apr 17, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 465422495 | CA | Primary |
Addresses
Primary practice location
248 3Rd St # 551
Oakland, CA 94607-4375
Mailing address
248 3Rd St # 551
Oakland, CA 94607-4375
Phone (510) 205-6707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 465422495 | CA | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397779200000",
"number": "1033539960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 3RD ST # 551",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946074375",
"telephone_number": "510-205-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 3RD ST # 551",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946074375",
"telephone_number": "510-205-6707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIER",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-17",
"last_updated": "2014-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "CA",
"license": "465422495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.