Ibraheem Al Shammaa

Individual provider Active NPI Basic Emergency Medical Technician · Berkeley, CA

NPI 1336940014 · NPPES record last updated Feb 17, 2026

Key facts

NPI
1336940014
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
License
E195911 (CA)
Practice address
2312 Ellsworth St
Berkeley, CA 94704-1562
Phone
(916) 892-9724
NPI assigned
Mar 20, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
E195911CAMDBasic Emergency Medical Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X E195911 CA Yes

Addresses

Primary practice location

2312 Ellsworth St
Berkeley, CA 94704-1562

Mailing address

2312 Ellsworth St
Berkeley, CA 94704-1562
Phone (916) 892-9724

Other providers in Berkeley, CA

All providers in Berkeley, CA · Basic Emergency Medical Technician in California

Sources for this page

Verify at the official NPI Registry.