Active NPI
Shadawn Parker
- Counselor
- San Jose, CA
National Provider Identifier
1366955114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1400 Parkmoor Ave
San Jose, CA 95126-3797 - Phone
- (408) 971-9822
- NPI assigned
- Nov 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1400 Parkmoor Ave
San Jose, CA 95126-3797
Mailing address
199 Cheltenham PL
San Jose, CA 95139-1415
Phone (267) 875-4242
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510617600000",
"number": "1366955114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 CHELTENHAM PL",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951391415",
"telephone_number": "267-875-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 PARKMOOR AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951263797",
"telephone_number": "408-971-9822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "SHADAWN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-14",
"last_updated": "2017-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.