Shin Newsom, RN, PHN, MPH

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

844268 Issued in CA

Practice address

5256 Mission Blvd
Riverside, CA 92509-4624

Phone

(951) 955-5326

NPI assigned

Jun 12, 2014

Sex

Male

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1427462902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4065 COUNTY CIRCLE DR STE 208",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5256 MISSION BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925094624",
            "telephone_number": "951-955-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOM",
        "first_name": "SHIN",
        "credential": "RN, PHN, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "844268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Registered Nurse in Riverside, CA
• Providers in Riverside, CA by specialty
• Case Management Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.