Shannon Martin, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

266499 Issued in CA

Practice address

22346 Hawthorn Ave
Moreno Valley, CA 92553-6988

Phone

(951) 842-9579

NPI assigned

Jan 5, 2017

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

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": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1952846537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23580 ALESSANDRO BLVD UNIT 9307",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925526128",
            "telephone_number": "951-842-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22346 HAWTHORN AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925536988",
            "telephone_number": "951-842-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "266499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel R Marsan, DO
• Shaniya Amaya Marshall
• Erania Marie Martin-Lang, MA
• Lisa Kathleen Martin, PHYSICAL THERAPIST
• Salima Martin
• Faith C Martinez-Ruiz
• Catherine Martinez-Vazquez
• Alexis Marie Martinez, PA-C
• Alexzes Martinez
• Cecilia Nicole Martinez, LVN

• Licensed Vocational Nurse in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.