Individual provider Active NPI

Georjana Grace Shames, L.AC.

  • Acupuncturist
  • San Rafael, CA
National Provider Identifier
1316197320
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
334133 Issued in LA
Practice address
25 Mitchell Blvd Ste 8
San Rafael, CA 94903-2013
Phone
(415) 388-0456
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 334133 LA Primary

Addresses

Primary practice location

25 Mitchell Blvd Ste 8
San Rafael, CA 94903-2013

Mailing address

224 Adobe LN
Rohnert Park, CA 94928-3959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
334133LAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1316197320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 ADOBE LN",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949283959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MITCHELL BLVD STE 8",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032013",
            "telephone_number": "415-388-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMES",
        "first_name": "GEORJANA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "LA",
            "license": "334133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.