Active NPI
Jeanette Wong Shibata, MSPA
- Physician Assistant
- Colton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 400 N. Pepper Ave
Colton, CA 92324 - Phone
- (909) 580-1000
- NPI assigned
- Sep 12, 2007
- Last updated
- Jun 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | CA | Primary |
Addresses
Primary practice location
400 N. Pepper Ave
Colton, CA 92324
Mailing address
8548 Quiet Woods St
Chino, CA 91708-9203
Phone (626) 318-1186
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients | |
| Cep America-California | Current | Accepting new patients |
Locations
400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400
1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125
1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545
Interoperability endpoints
- jeanette.shibata@398008301912068.direct.elationemr.com
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Los Angeles, CA
- NPI 1770886558
-
- Health Service Clinic/Center
- Santa Ana, CA
- NPI 1053187187
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275868800000",
"number": "1306031448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8548 QUIET WOODS ST",
"city": "CHINO",
"state": "CA",
"postal_code": "917089203",
"telephone_number": "626-318-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N. PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "92324",
"telephone_number": "909-580-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIBATA",
"first_name": "JEANETTE",
"middle_name": "WONG",
"name_prefix": "Mrs.",
"credential": "MSPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-12",
"last_updated": "2010-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.