Shannon Rose Sickle, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95016166 Issued in CA

Practice address

1325 Travis Blvd Ste C
Fairfield, CA 94533-4611

Phone

(707) 398-8916

NPI assigned

Jul 7, 2015

Last updated

Jun 12, 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 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • North Highlands, CA
  • NPI 1184677163
  Medicare reassignment NPD
• Planned Parenthood Shasta Diablo Inc

  • Community Health Clinic/Center
  • Concord, CA
  • NPI 1982763090
  Medicare reassignment NPD
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • Yuba City, CA
  • NPI 1255387106
  NPD
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • Roseville, CA
  • NPI 1447206321
  NPD
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • Sacramento, CA
  • NPI 1679526610
  NPD
• Planned Parenthood Mar Monte, Inc.

  dba Mar Monte Community Clinic

  • Community Health Clinic/Center
  • San Jose, CA
  • NPI 1598536971
  NPD
• Planned Parenthood Shasta Diablo Inc

  dba Planned Parenthood Northern California

  • Community Health Clinic/Center
  • Chico, CA
  • NPI 1558420695
  NPD
• Planned Parenthood Shasta Diablo Inc

  dba Planned Parenthood Northern California

  • Clinical Medical Laboratory
  • San Rafael, CA
  • NPI 1750435244
  NPD

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1851774962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262203",
            "telephone_number": "408-287-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TRAVIS BLVD STE C",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334611",
            "telephone_number": "707-398-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICKLE",
        "first_name": "SHANNON",
        "middle_name": "ROSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95231874",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donovan Paul Shively, MD
• Nadin Shoufi, CPBMT
• Camilia Kaye Shoulders, M.S.
• Kathleen Sianghio, NP
• Bernard Siao
• Parveen Sidhu-Bhullar
• Gurmeet S. Sidhu, MD
• Steven Eric Siegal, M.D.
• Vanessa Siegel
• Surnetta Sihn

• Family Nurse Practitioner in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.