Sha'Tara L Stevenson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

309 E Mountain View St Ste 101102
Barstow, CA 92311-2814

Phone

(760) 256-7279

NPI assigned

Jan 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• LSS Community Care Center

  • Community/Behavioral Health Agency
  • Barstow, CA
  • NPI 1265838023
  NPD (past)

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124536073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1927",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923151927",
            "telephone_number": "909-866-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E MOUNTAIN VIEW ST STE 101102",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112814",
            "telephone_number": "760-256-7279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 E Mountain View St Ste 101102",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923112814",
            "country_code": "US",
            "telephone_number": "760-269-2697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 E Virginia Way Apt 134",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923113964",
            "country_code": "US",
            "telephone_number": "760-269-2697",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 E Mountain View St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923112814",
            "country_code": "US",
            "telephone_number": "760-256-7279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "SHA'TARA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Barstow, CA
• Providers in Barstow, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.