Individual provider Active NPI

Shakti Nammu D'Arc-En Ciel

  • Student in an Organized Health Care Education/Training Program
  • Eureka, CA
National Provider Identifier
1083583488
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1802 California St
Eureka, CA 95501-2808
Phone
(707) 443-7358
NPI assigned
Nov 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1802 California St
Eureka, CA 95501-2808

Mailing address

PO Box 2005
Eureka, CA 95502-2005
Phone (707) 443-7358

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

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt Family Service Center CurrentSince Nov 9, 2025 Accepting new patients

Locations

1802 California St
Eureka, CA 95501
Phone (707) 443-7358

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1083583488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955022005",
            "telephone_number": "707-443-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 CALIFORNIA ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955012808",
            "telephone_number": "707-443-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ARC-EN CIEL",
        "first_name": "SHAKTI",
        "middle_name": "NAMMU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "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 Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.