Individual provider Active NPI

Shalene Williams, PHARMD

  • Pharmacist
  • Sonora, CA
National Provider Identifier
1417667148
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
87253 Issued in CA
Practice address
1101 Sanguinetti Rd
Sonora, CA 95370-6214
Phone
(209) 533-2617
NPI assigned
Dec 5, 2022
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 87253 CA Primary

Addresses

Primary practice location

1101 Sanguinetti Rd
Sonora, CA 95370-6214

Mailing address

22554 Colorado River Dr
Sonora, CA 95370-8334
Phone (209) 770-0910

Other names 1

  • Shalene Fender Former name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
87253CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1417667148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22554 COLORADO RIVER DR",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953708334",
            "telephone_number": "209-770-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SANGUINETTI RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953706214",
            "telephone_number": "209-533-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHALENE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHALENE",
            "last_name": "FENDER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.