Individual provider Active NPI

Jeffrey Kent Shinoda, PHARM.D.

  • Pharmacist
  • Fresno, CA
National Provider Identifier
1508872433
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH41852 Issued in CA
Practice address
6121 N Thesta St Ste 204
Fresno, CA 93710-5294
Phone
(559) 435-2425
Fax
(559) 438-4372
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH41852 CA Primary
Oncology Pharmacist 1835X0200X RPH41852 CA

Addresses

Primary practice location

6121 N Thesta St Ste 204
Fresno, CA 93710-5294

Mailing address

6121 N Thesta St Ste 204
Fresno, CA 93710-5294
Phone (559) 435-2425

Other identifiers 3

IdentifierTypeStateIssuer
LSC99279OtherCASTERILE CPD LICENSE-PHARM
PHY47019OtherCAPHARMACY LICENSE
RPH41852OtherCAPHARMACIST 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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH41852CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508872433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST STE 204",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105294",
            "telephone_number": "559-435-2425",
            "fax_number": "559-438-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST STE 204",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105294",
            "telephone_number": "559-435-2425",
            "fax_number": "559-438-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINODA",
        "first_name": "JEFFREY",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH41852",
            "primary": true
        },
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "CA",
            "license": "RPH41852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERILE CPD LICENSE-PHARM",
            "identifier": "LSC99279",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PHY47019",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE.",
            "identifier": "RPH41852",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.