SHANNON HEUKLOM (NPI# 1144686312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144686312 |
| Entity Type | Individual |
| Full Name | SHANNON HEUKLOM |
| Other Name | SHANNON STAPLES |
| Credential | MSN, MPH, AGPCNP-BC |
| Practice Address |
330 Ellis St 6th Floor San Francisco CA 94102-2735 |
| Practice Telephone | 4014408056 |
| Mailing Telephone | 4156746140 |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2017-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
95003581 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
330 ELLIS ST 6TH FLOOR |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94102-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790749091 | Patricia Mary Dennehy | Nurse Practitioner | 330 Ellis St, Glide Health Services, Suite 518, San Francisco, CA 94102-2735 | 2006-04-13 |
| 1265866446 | Vanessa M Dempsey | Nurse Practitioner | 330 Ellis St, San Francisco, CA 94102-2735 | 2013-08-24 |
| 1225477532 | Tony Anh Nguyen | Pharmacist | 330 Ellis St, 6th Floor (health Clinic), San Francisco, CA 94102-2735 | 2013-06-19 |
| 1841635000 | Jolie Marie Hoppe Macrito | Hospitalist | 330 Ellis St, San Francisco, CA 94102 | 2013-05-01 |
| 1164765061 | Bahare Farhadian | Nurse Practitioner | 330 Ellis St, San Francisco, CA 94102-2735 | 2013-03-29 |
| 1497030241 | Lisa Masai | Registered Nurse | 330 Ellis St, C/o Glide Health Services, San Francisco, CA 94102-2735 | 2011-10-12 |
| 1467667469 | Sandra C Prentice | Nurse Practitioner | 330 Ellis St, San Francisco, CA 94102-2735 | 2007-05-11 |
| 1861520504 | Christina Macdonald Fraser Clark | Nurse Practitioner | 330 Ellis St, Glide Health Services, San Francisco, CA 94102-2735 | 2007-03-02 |
| 1063559243 | Kenneth Hyo-kyung Kim | Psychologist | 330 Ellis St, San Francisco, CA 94102-2735 | 2007-01-30 |
| 1447279310 | Healthright 360 | Clinic/Center | 330 Ellis St, San Francisco, CA 94102-2735 | 2006-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043849318 | Alvin Vallejo | Registered Nurse | 30 Van Ness, Suite 2300, San Francisco, CA 94102 | 2020-04-07 |
| 1831731041 | Erica Keller | Physician Assistant | 1998 Market Street, Within Carbon Health, San Francisco, CA 94102 | 2019-10-09 |
| 1790342368 | Emma Victoria Mc Arthur | Acupuncturist | 364 Hayes Street, Second Floor, San Francisco, CA 94102 | 2019-05-20 |
| 1265926489 | Sharon Lee Haynes | Counselor | 711 Van Ness Ave Ste 500, San Francisco, CA 94102 | 2018-06-20 |
| 1487166898 | Therapia Health Management Inc. | Clinic/Center | 1390 Market St. Suite 200, San Francisco, CA 94102 | 2017-10-26 |
| 1700395456 | Faiza Saeed | Community Health Worker | 315 Turk Street, San Francisco, CA 94102 | 2017-09-26 |
| 1093255184 | Abigail Roh | Counselor | 50 Ivy St., San Francisco, CA 94102 | 2017-03-08 |
| 1598214173 | See Saw Seen Optometry | Optometrist | 515 Gough Street, San Francisco, CA 94102 | 2016-09-24 |
| 1841744505 | Kyra Lee | Dentist | 490 Post St Ste 1450, San Francisco, CA 94102 | 2016-08-11 |
| 1255702528 | Jins Eyewear Us, Inc. | Technician/Technologist | 151 Powell St., San Francisco, CA 94102 | 2015-10-13 |
| Find all providers in zip 94102 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982257390 | Sara Jennifer Benson | Nurse Practitioner | 180 Redwood St Ste 350, San Francisco, CA 94102-3282 | 2019-07-24 |
| 1437719861 | Allison Jayne Frank | Nurse Practitioner | 2040 Franklin St Apt 1007, San Francisco, CA 94109-2904 | 2019-06-18 |
| 1578022927 | Daniel Dewey Cline | Nurse Practitioner | 2960 Diamond St Apt 2, San Francisco, CA 94131-3241 | 2019-03-15 |
| 1760987432 | Chris Jungboo Lee | Nurse Practitioner | 320 Guttenberg St, San Francisco, CA 94112-4348 | 2018-03-26 |
| 1649780883 | Elicia Fox Chaney | Nurse Practitioner | 505 Parnassus Ave # L352, San Francisco, CA 94143-2204 | 2017-10-02 |
| 1336591585 | Lizbeth Gibson | Nurse Practitioner | 400 Parnassus Ave Ste A808, San Francisco, CA 94143-2202 | 2016-07-11 |
| 1063814481 | Mary Rebecca Conroy | Nurse Practitioner | 3333 California Street. Ucsf Division of Geriatrics, Suite 380, San Francisco, CA 94118 | 2014-09-17 |
| 1780016428 | Reena Gupta | Nurse Practitioner | 126 Post St, San Francisco, CA 94108-4713 | 2013-08-05 |
| 1548607948 | Abigail Fairlie Bruce Carvalho | Nurse Practitioner | 1035 Lincoln Way, San Francisco, CA 94122-2217 | 2013-05-27 |
| 1336585256 | Tala A Montoya | Nurse Practitioner | 360 Hamilton St, #3, San Francisco, CA 94134-1472 | 2013-05-18 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94102 |
Please comment or provide details below to improve the information on SHANNON HEUKLOM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.