Active NPI
Judah O'Shaughnessy, RN
- Registered Nurse
- Eureka, CA
National Provider Identifier
1053199901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95341635
- Practice address
- 1205 Myrtle Ave
Eureka, CA 95501-1224 - Phone
- (707) 601-6932
- NPI assigned
- Sep 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 95341635 | CA | |
| Registered Nurse | 163W00000X | 95341635 | CA | Primary |
Addresses
Primary practice location
1205 Myrtle Ave
Eureka, CA 95501-1224
Mailing address
PO Box 1332
Eureka, CA 95502-1332
Phone (707) 798-7451
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95341635 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1053199901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1332",
"city": "EUREKA",
"state": "CA",
"postal_code": "955021332",
"telephone_number": "707-798-7451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 MYRTLE AVE",
"city": "EUREKA",
"state": "CA",
"postal_code": "955011224",
"telephone_number": "707-601-6932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'SHAUGHNESSY",
"first_name": "JUDAH",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-20",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "95341635",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95341635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.