Individual provider Active NPI

Shannon Tam, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1235619685
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95021932 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 734-7595
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95070467 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95021932 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

1001 Potrero Ave
San Francisco, CA 94110-3518

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
I20230120002422 CA Practitioner - Nurse Practitioner 2062883416 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95070467CAMDPsychiatric/Mental Health Registered Nurse
95021932CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Psychiatry CurrentSince Nov 1, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 1, 2023 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
University of California San Francisco CurrentSince Nov 1, 2023 Accepting new patients
University of California San Francisco CurrentSince Nov 1, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 1, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 1, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 1, 2023 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

225 California Dr
Burlingame, CA 94010
Phone (415) 353-2002

2230 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2614

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

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

1600 Divisadero St
San Francisco, CA 94143
Phone (415) 353-7175

675 18th St
San Francisco, CA 94143
Phone (415) 476-7527

2001 The Embarcadero
Ofc Of
San Francisco, CA 94143
Phone (628) 224-5503

401 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-7500

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

401 Parnassus Ave
#984
San Francisco, CA 94143
Phone (415) 476-7527

Interoperability endpoints

  • Direct secure messaging: stam327170@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1235619685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95070467",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.