Individual provider Active NPI

Shona Deundra Tate

  • Rehabilitation Practitioner
  • Banning, CA
National Provider Identifier
1407797566
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
63 S 4TH St
Banning, CA 92220-4861
Phone
(951) 837-3745
NPI assigned
Apr 2, 2026
Last updated
Apr 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

63 S 4TH St
Banning, CA 92220-4861

Mailing address

255 N Soboba St
Hemet, CA 92544-5125
Phone (951) 837-3745

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": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1407797566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N SOBOBA ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925445125",
            "telephone_number": "951-837-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 S 4TH ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922204861",
            "telephone_number": "951-837-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "SHONA",
        "middle_name": "DEUNDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Banning, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.