Chardonnay Shinn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

51875 Issued in CA

Practice address

5 Journey
Suite #130
Aliso Viejo, CA 92656-5336

Phone

(949) 360-1069

NPI assigned

Oct 24, 2014

Sex

Female

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oc Family Medicine PC

  • Family Medicine Physician
  • Aliso Viejo, CA
  • NPI 1700515731
  NPD

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1467857078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 JOURNEY",
            "address_2": "SUITE #130",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565336",
            "telephone_number": "949-360-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 JOURNEY",
            "address_2": "SUITE #130",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565336",
            "telephone_number": "949-360-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINN",
        "first_name": "CHARDONNAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadaf Shalchian Pourkhaljan, LMFT
• Smriti Shamapant, DACM, LAC, DIPL. OM
• Azadeh Shams
• Gabrielle Lorraine Shaw
• Shift Happens, Marriage and Family Therapy, Pro Corp
• Scott Lyman Shreeve, MD
• Tanya Faelnar Sim
• Daljeet Singh, MD
• Guneet Singh
• Shivani Singh

• Physician Assistant in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.