Shana M Gibbons, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN95178653 Issued in CA

Practice address

1209 W Tokay St
Lodi, CA 95240-3845

Phone

(209) 331-2070

NPI assigned

Apr 16, 2019

Last updated

Apr 16, 2019By the provider in NPPES

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1376106203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8645 NEMEA WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956243445",
            "telephone_number": "623-455-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W TOKAY ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403845",
            "telephone_number": "209-331-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "SHANA",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "RN95178653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fatema Manekia Ghani, DPT
• Mobin P Ghavami, M.D.
• Ghozlan Dental Corp.
• Ayman Ghozlan
• Phuong Thu Giao, DDS
• Norielyn Gier
• Donna L Gilbert
• Gill and Patel Dental Corporation (Dentists of Lodi Dental Group)
• Gill Dalla Dental Inc (Modern Dental and Implants)
• Gill Medical Group, Inc.

• Psychiatric/Mental Health Registered Nurse in Lodi, CA
• Providers in Lodi, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.