Shane' S Bundy, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

89911 Issued in CA

Practice address

25345 Woodcreek CT
Moreno Valley, CA 92553-4445

Phone

(951) 534-9011

NPI assigned

Mar 9, 2023

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

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1679273445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013",
            "telephone_number": "323-766-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25345 WOODCREEK CT",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534445",
            "telephone_number": "951-534-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDY",
        "first_name": "SHANE'",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "89911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trang Thi Diem Bui, PHARMD
• Tuyen Bui
• Lavalle Deprice Bullard
• Sheneia T Bullard
• Ryan Buller, D.O.
• Courtney Burgdorff, MD
• Jordyn Larissa Burgess
• Christina Burkhardt, D.C.
• Patrick Curtis Burrell, N.D.
• Tristen Burt, DO

• Clinical Social Worker in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.