Active NPI
Krystal Shin, PA-C
- Physician Assistant
- San Francisco, CA
National Provider Identifier
1427536754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 55666
- Practice address
- 2100 Webster St Ste 305
San Francisco, CA 94115-2376 - Phone
- (415) 202-1540
- NPI assigned
- Jul 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 55666 | CA | Primary |
Addresses
Primary practice location
2100 Webster St Ste 305
San Francisco, CA 94115-2376
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Phone (415) 202-1540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55666 | Other | CA | STATE MEDICAL LICENSE |
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624492800000",
"number": "1427536754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 DISTEL CIR",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940221408",
"telephone_number": "415-202-1540",
"fax_number": "415-202-1543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 WEBSTER ST STE 305",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152376",
"telephone_number": "415-202-1540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "KRYSTAL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-30",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "55666",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "55666",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.