Individual provider Active NPI

Jacqueline Sasha Shirvan, BSN, RN

  • Adult Psychiatric/Mental Health Registered Nurse
  • Hammonton, NJ
National Provider Identifier
1669334546
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
26NR26711300 Issued in NJ
Practice address
301 Spring Garden Rd
Hammonton, NJ 08037-9699
Phone
(609) 561-1700
NPI assigned
Nov 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 26NR26711300 NJ Primary

Addresses

Primary practice location

301 Spring Garden Rd
Hammonton, NJ 08037-9699

Mailing address

105 Columbia Ave
Stratford, NJ 08084-1119
Phone (856) 220-1126

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR26711300NJMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1764288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1669334546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COLUMBIA AVE",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841119",
            "telephone_number": "856-220-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SPRING GARDEN RD",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080379699",
            "telephone_number": "609-561-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRVAN",
        "first_name": "JACQUELINE",
        "middle_name": "SASHA",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-28",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NR26711300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; 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.