Shannon Marie Goulmassian, RN, CNS

Primary specialty

Perinatal Clinical Nurse SpecialistTaxonomy code 364SP1700X

License

1382 Issued in CA

Practice address

1725 Western Ave
San Bernardino, CA 92411-1367

Phone

(909) 887-6333

NPI assigned

Nov 28, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1437426053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10967",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230967",
            "telephone_number": "909-796-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 WESTERN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111367",
            "telephone_number": "909-887-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULMASSIAN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN, CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "536211",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "L-17087",
            "primary": false
        },
        {
            "code": "364SP1700X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perinatal",
            "state": "CA",
            "license": "1382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Anna Gorton
• Gospha G, Campbell MD Inc
• Shalane Dominique Goss
• Ebony Gould
• Madeline Gould
• Brenda Alejandra Govea
• Nadine Grace-Abraham, MD
• Del Grace
• Gracevine Healthcare SVCS a Professnal Nursing Corp
• Emely Gracia

• Clinical Nurse Specialist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.