Individual provider Active NPI

Kathryn Shedden

  • Nurse's Aide
  • Lancaster, CA
National Provider Identifier
1407635097
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
00747986 Issued in CA
Practice address
45465 25TH St E SPC 296
Lancaster, CA 93535-1003
Phone
(951) 577-6803
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 00227135 CA
Nurse's Aide 376K00000X 00747986 CA Primary

Addresses

Primary practice location

45465 25TH St E SPC 296
Lancaster, CA 93535-1003

Mailing address

45465 25TH St E SPC 296
Lancaster, CA 93535-1003
Phone (951) 577-6803

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
00227135CAMDHome Health Aide
00747986CAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1407635097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45465 25TH ST E SPC 296",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935351003",
            "telephone_number": "951-577-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45465 25TH ST E SPC 296",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935351003",
            "telephone_number": "951-577-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDDEN",
        "first_name": "KATHRYN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "CA",
            "license": "00227135",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "CA",
            "license": "00747986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.