Individual provider Active NPI

Shenna Samaniego, NP

  • Family Nurse Practitioner
  • San Mateo, CA
National Provider Identifier
1609709633
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95039518 Issued in CA
Practice address
1670 S Amphlett Blvd Ste 300
San Mateo, CA 94402-2534
Phone
(650) 685-2830
NPI assigned
Jun 8, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95039518 CA Primary

Addresses

Primary practice location

1670 S Amphlett Blvd Ste 300
San Mateo, CA 94402-2534

Mailing address

1670 S Amphlett Blvd Ste 300
San Mateo, CA 94402-2534
Phone (650) 685-2830

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

NPI Registry JSON

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

{
    "created_epoch": "1780876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1609709633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 S AMPHLETT BLVD STE 300",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022534",
            "telephone_number": "650-685-2830",
            "fax_number": "650-347-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 S AMPHLETT BLVD STE 300",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022534",
            "telephone_number": "650-685-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANIEGO",
        "first_name": "SHENNA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95039518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.