Kiara Shantal Shaw, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

712683 Issued in CA

Practice address

4994 Sudbury Way
Fontana, CA 92336-0684

Phone

(951) 570-3577

NPI assigned

May 19, 2023

Sex

Female

Sole proprietor

Yes

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1689365629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4994 SUDBURY WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4994 SUDBURY WAY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360684",
            "telephone_number": "951-570-3577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 E Foothill Blvd",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911073439",
            "country_code": "US",
            "telephone_number": "951-570-3577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KIARA",
        "middle_name": "SHANTAL",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "712683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances E. Sharpe, MD
• William G. Sharra III, MD
• Amanda Shaw
• Johnathan Shaw
• Kiana R Shaw
• Matthew Shaw, CRNA
• Candice Shearer, DPT
• Paula Ann Shearer
• Vivian Akosua Sheets
• Lisamarie Shelton, PSYCHOLOGIST

• Licensed Vocational Nurse in Fontana, CA
• Providers in Fontana, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.