Shannon Marjorie Fish, SHANNON FISH PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17422 Issued in CA

Practice address

450 Broadway St
Pavilion a, 1St Floor
Redwood City, CA 94063-3132

Phone

(650) 723-6238

Fax

(650) 721-3417

NPI assigned

May 21, 2008

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  NPD (past)
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  NPD (past)

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1255598793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROADWAY ST",
            "address_2": "PAVILION A, 1ST FLOOR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633132",
            "telephone_number": "650-723-6238",
            "fax_number": "650-721-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROADWAY ST",
            "address_2": "PAVILION A, 1ST FLOOR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633132",
            "telephone_number": "650-723-6238",
            "fax_number": "650-721-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "SHANNON",
        "middle_name": "MARJORIE",
        "name_prefix": "Ms.",
        "credential": "SHANNON  FISH PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Health Care, Inc.
• First Optometric Care of Northern California PC
• Grace W. Firtch, MD
• Allyson Anders Fisch, GNP, RD
• Brian Fischer, PT, DPT
• Jan L Fisher, PHD
• Robert B Fisher, M.D.
• Fitness Reloaded LLC
• Ruthann Flament, NP
• Thomaz Antonio A Fleury Curado, MD

• Medical Physician Assistant in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.