SHANNON MICHAEL GENNETTE (NPI# 1336786144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336786144 |
| Entity Type | Individual |
| Full Name | SHANNON MICHAEL GENNETTE |
| Practice Address |
751 S Bascom Ave San Jose CA 95128-2699 |
| Practice Telephone | 4088852454 |
| Mailing Telephone | 4088852454 |
| Enumeration Date | 2019-11-30 |
| Last Update Date | 2019-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95012678 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
751 S BASCOM AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-2699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396743217 | Ellen Perez Travis | Nurse Practitioner | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2005-07-13 |
| 1235738691 | Alina Bogdanovich | Registered Nurse | 751 S Bascom Ave, San Jose, CA 95128-2699 | 2020-10-17 |
| 1255946380 | Kimberly Red Soria | Nurse Practitioner | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-09-15 |
| 1568072403 | Emily Win Hou | Pharmacist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-08-05 |
| 1649880063 | Katherine Ann Trescott | Speech-Language Pathologist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-08-01 |
| 1992320386 | Gino Dizon Legaspi | Physical Therapy Assistant | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-06-11 |
| 1215552732 | Emily Louise Masad | Physician Assistant | 751 S Bascom Ave, San Jose, CA 95128-2699 | 2020-06-10 |
| 1790300341 | Laura Muzzatti | Physical Therapist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-06-09 |
| 1679195085 | Raymond Chao | Pharmacist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-05-08 |
| 1407476765 | Yoo Jung Kim | Student in an Organized Health Care Education/Training Program | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565738 | Lena Kil | Nurse Practitioner | 3680 Greenlee Dr Apt 4, San Jose, CA 95117-1469 | 2020-10-09 |
| 1740893858 | Esther Kiang | Nurse Practitioner | 1072 E Santa Clara St, San Jose, CA 95116-2245 | 2020-08-28 |
| 1902419575 | Leonard Iskander | Nurse Practitioner | 1146 Summerpark Ct, San Jose, CA 95132-2944 | 2020-08-25 |
| 1760004055 | Destiny Ann Brewer | Nurse Practitioner | 4735 Hamilton Ave # 80, San Jose, CA 95130-1769 | 2020-05-11 |
| 1841825148 | Marta Anna Sivarajah | Nurse Practitioner | 255 N. White Rd., San Jose, CA 95127-1966 | 2020-03-06 |
| 1114567500 | Sabine Dorothea Haas | Nurse Practitioner | 1879 Lundy Ave Ste 233, San Jose, CA 95131-1881 | 2020-01-14 |
| 1861033870 | Jessica Gutierrez | Nurse Practitioner | 635 S 11th St Apt 14, San Jose, CA 95112-2343 | 2019-10-01 |
| 1124589379 | Yvonne Ndeh | Nurse Practitioner | 418 Shadowgraph Dr, San Jose, CA 95110-3564 | 2019-03-29 |
| 1588139661 | Vicky Chi Lin | Nurse Practitioner | 100 Oak St Rm F-3, San Jose, CA 95110-2817 | 2018-10-04 |
| 1851884381 | Anh Tuan Huynh | Nurse Practitioner | 3100 Rubino Dr Apt 310, San Jose, CA 95125-6369 | 2018-06-09 |
| Find all providers in SAN JOSE | ||||
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| 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.