Individual provider Active NPI

Jacqueline Ethel McShane, RN IBCLC

  • Lactation Consultant (Registered Nurse)
  • Eureka, CA
National Provider Identifier
1801004486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
178385 Issued in CA
Practice address
5095 Woodland Way
Eureka, CA 95503-9785
Phone
(707) 599-3652
Fax
(707) 443-5300
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 178385 CA Primary

Addresses

Primary practice location

5095 Woodland Way
Eureka, CA 95503-9785

Mailing address

5095 Woodland Way
Eureka, CA 95503-9785
Phone (707) 599-3652

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
178385CAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801004486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5095 WOODLAND WAY",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955039785",
            "telephone_number": "707-599-3652",
            "fax_number": "707-443-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5095 WOODLAND WAY",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955039785",
            "telephone_number": "707-599-3652",
            "fax_number": "707-443-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSHANE",
        "first_name": "JACQUELINE",
        "middle_name": "ETHEL",
        "name_prefix": "Mrs.",
        "credential": "RN IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "178385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.