Individual provider Active NPI

Shannon Hurley Raber, CPNP-AC

  • Pediatric Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1194087262
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
18460 Issued in CA
Practice address
505 Parnassus Ave
Box 0106
San Francisco, CA 94143-0106
Phone
(415) 476-3831
Fax
(415) 476-9068
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 18460 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
Box 0106
San Francisco, CA 94143-0106

Mailing address

505 Parnassus Ave
Box 0106
San Francisco, CA 94143-0106
Phone (415) 476-3831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120815000379 CA Practitioner - Nurse Practitioner 5698921104 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Jul 1, 2012 Accepting new patients
UCSF Pediatrics Associates CurrentSince Jul 1, 2012 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2012 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Jan 15, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jan 15, 2018 Accepting new patients

Locations

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

505 Parnassus Ave
#106
San Francisco, CA 94143
Phone (415) 476-3831

Organizations & group practices 6

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1194087262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "address_2": "BOX 0106",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430106",
            "telephone_number": "415-476-3831",
            "fax_number": "415-476-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "address_2": "BOX 0106",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430106",
            "telephone_number": "415-476-3831",
            "fax_number": "415-476-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABER",
        "first_name": "SHANNON",
        "middle_name": "HURLEY",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "18460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.