Imani L Shannon

Primary specialty

DriverTaxonomy code 172A00000X

License

F7077821 Issued in CA

Practice address

1919 Grand Canal Blvd
Stockton, CA 95207-8135

Phone

(415) 423-4476

NPI assigned

Aug 25, 2023

Last updated

Aug 25, 2023By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1801671177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 GRAND CANAL BLVD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078135",
            "telephone_number": "415-423-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 GRAND CANAL BLVD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078135",
            "telephone_number": "415-423-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "IMANI",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "F7077821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia Shaikh, M.D.
• Edward E Shakespeare
• Ibrahim Shakur
• Tina Marie Shandrew
• Sara Shane, LMFT
• Shapiro Chiropractic Inc.
• Peggy Rose Shapiro
• Robert John Shapiro, D.C.
• Valerie Shapiro, CRNA
• Geetu Sharma, DDS, MPH, BDS

• Driver in Stockton, CA
• Providers in Stockton, CA by specialty
• Driver in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.