Allisen Elaine Shaw, OTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1199 Issued in CA

Practice address

3620 Dale Rd Ste B
Modesto, CA 95356-0598

Phone

(209) 450-9205

NPI assigned

Mar 22, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Allisen Elaine Brown Former name

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": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1891545018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 SUZANNE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953502872",
            "telephone_number": "209-450-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 DALE RD STE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953560598",
            "telephone_number": "209-450-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALLISEN",
        "middle_name": "ELAINE",
        "credential": "OTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "1199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISEN",
            "last_name": "BROWN",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Girgis F Sharmoukh, M.D.
• Craig Lee Sharp III, D.C.
• Diane Vincent Sharp
• Shashi .T Sood M.D., Inc
• Deborah A Shassetz, D.O.
• Amy Shaw
• Destiny Shaw
• Michael P. Shaw, DDS
• Manpreet Kaur Sheabat, PA
• Michael Shear

• Occupational Therapy Assistant in Modesto, CA
• Providers in Modesto, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.