Individual provider Active NPI

Shanda Marie Fuller, D.C.

  • Chiropractor
  • Danville, CA
National Provider Identifier
1912925298
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27288 Issued in CA
Practice address
565 Sycamore Valley Rd W
Danville, CA 94526-3900
Phone
(925) 837-5595
Fax
(925) 837-6558
NPI assigned
Jul 17, 2006
Last updated
Oct 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27288 CA Primary

Addresses

Primary practice location

565 Sycamore Valley Rd W
Danville, CA 94526-3900

Mailing address

565 Sycamore Valley Rd W
Danville, CA 94526-3900
Phone (925) 837-5595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304001307 CA Practitioner - Chiropractic 0648168427 Practice locations: Danville, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

318 Diablo Rd
Suite 245
Danville, CA 94526-3464
Phone (925) 290-1830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC27288CAMDChiropractor
27288CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fuller Chiropractic Inc Chiropractor Past Accepting new patients
Zamora Chiropractic Inc Chiropractor PastSince Aug 23, 2020 Accepting new patients
Hall Family Chiropractic Inc Chiropractor Past Accepting new patients
Madeline Duncan Chiropractic Corporation Chiropractor PastSince Feb 2, 2025 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288224000000",
    "number": "1912925298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 SYCAMORE VALLEY RD W",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945263900",
            "telephone_number": "925-837-5595",
            "fax_number": "925-837-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 SYCAMORE VALLEY RD W",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945263900",
            "telephone_number": "925-837-5595",
            "fax_number": "925-837-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SHANDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.