Individual provider Active NPI

Lauren Shaw

  • Physician Assistant
  • Folsom, CA
National Provider Identifier
1720888316
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA67234 Issued in CA
Practice address
82 Clarksville Rd Ste 120
Folsom, CA 95630-8210
Phone
(916) 983-8868
NPI assigned
Mar 14, 2025
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA67234 CA Primary

Addresses

Primary practice location

82 Clarksville Rd Ste 120
Folsom, CA 95630-8210

Mailing address

2416 50TH St
Sacramento, CA 95817-1503
Phone (530) 524-2326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251125003131 CA Practitioner - Physician Assistant 7012409147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Living Primary Care IncGroup PAC ID 7618062225, 20 clinicians

Practice addresses (Care Compare)

82 Clarksville Rd
Suite 120
Folsom, CA 95630-8210
Phone (916) 983-8868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA67234CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Living Primary Care, Inc CurrentSince Dec 1, 2025 Accepting new patients

Locations

11634 Fair Oaks Blvd
Fair Oaks, CA 95628
Phone (916) 852-6001

82 Clarksville Rd
Ste 120
Folsom, CA 95630
Phone (916) 299-9859

Interoperability endpoints

  • Direct secure messaging: lshaw241277@hpmg.direct-ci.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1720888316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 50TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171503",
            "telephone_number": "530-524-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 CLARKSVILLE RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308210",
            "telephone_number": "916-983-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.