Active NPI
Shyla Marie Harrell
- Phlebotomy Technician
- Antioch, CA
National Provider Identifier
1679229140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- CPT-02240950
- Practice address
- 2704 Roosevelt LN
Antioch, CA 94509-5037 - Phone
- (925) 234-5202
- NPI assigned
- Feb 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | CPT-02240950 | CA | Primary |
Addresses
Primary practice location
2704 Roosevelt LN
Antioch, CA 94509-5037
Mailing address
2704 Roosevelt LN
Antioch, CA 94509-5037
Phone (925) 234-5202
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPT-02240950 | CA | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1679229140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2704 ROOSEVELT LN",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945095037",
"telephone_number": "925-234-5202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2704 ROOSEVELT LN",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945095037",
"telephone_number": "925-234-5202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "SHYLA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-23",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "CA",
"license": "CPT-02240950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.