Individual provider Active NPI

Shimona Brezil Menezes

  • Pharmacist
  • Fullerton, CA
National Provider Identifier
1457943219
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
83518 Issued in CA
Practice address
1930 N Placentia Ave # 819
Fullerton, CA 92831-1522
Phone
(714) 792-0990
NPI assigned
Feb 3, 2021
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 83518 CA Primary

Addresses

Primary practice location

1930 N Placentia Ave # 819
Fullerton, CA 92831-1522

Mailing address

1930 N Placentia Ave # 819
Fullerton, CA 92831-1522
Phone (714) 792-0990

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

State licenses

LicenseStateTypeSpecialty
83518CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1457943219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 N PLACENTIA AVE # 819",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311522",
            "telephone_number": "714-792-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 N PLACENTIA AVE # 819",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311522",
            "telephone_number": "714-792-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENEZES",
        "first_name": "SHIMONA",
        "middle_name": "BREZIL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "83518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.

Verify at the official NPI Registry.