Active NPI
Latasha Shaw, LVN
- Licensed Vocational Nurse
- Bakersfield, CA
National Provider Identifier
1811401482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 290342
- Practice address
- 1014 Calloway Dr
Bakersfield, CA 93312-6337 - Phone
- (661) 630-7600
- NPI assigned
- Nov 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 290342 | CA | Primary |
Addresses
Primary practice location
1014 Calloway Dr
Bakersfield, CA 93312-6337
Mailing address
8100 Spartans Dr
Bakersfield, CA 93313-5449
Phone (661) 912-7169
Other practice location 1
3409 Calloway Dr
Bakersfield, CA 93312-2528
Phone (800) 300-6664
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290342 | CA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Family Health | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Delano, CA
- NPI 1417962457
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1811401482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8100 SPARTANS DR",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933135449",
"telephone_number": "661-912-7169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 CALLOWAY DR",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933126337",
"telephone_number": "661-630-7600"
}
],
"practiceLocations": [
{
"address_1": "3409 Calloway Dr",
"address_purpose": "LOCATION",
"city": "Bakersfield",
"state": "CA",
"postal_code": "933122528",
"country_code": "US",
"telephone_number": "800-300-6664",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAW",
"first_name": "LATASHA",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "290342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.