Tyana Shaw

Primary specialty

Clinical & Laboratory Immunology (Internal Medicine) PhysicianTaxonomy code 207RI0001X

License

207RI0001 Issued in CA

Practice address

4965 Ridgeview Dr
Antioch, CA 94531-7757

Phone

(510) 703-2130

NPI assigned

Oct 20, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668211200000",
    "number": "1669199642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 RIDGEVIEW DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945317757",
            "telephone_number": "510-703-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 RIDGEVIEW DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945317757",
            "telephone_number": "510-703-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TYANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-11-12",
        "certification_date": "2022-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "CA",
            "license": "207RI0001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alton Seymore
• Yesha Kaushik Shah, DO
• Alana Frost Shain, MD
• Sahar Sharifzie
• Nathan Shaver
• Sheffield and Le Orthodontics
• Robert E Sheffield, DDS
• Shelby J. Smith, DDS, Ms, a Professional Corporation
• Nicole Kathryn Shelton, M.D.
• Ananth Shenoy, M.D.

• Internal Medicine Physician in Antioch, CA
• Providers in Antioch, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2022; 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.