ANNETTE AMBITO SHEPHERD (NPI# 1417441130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417441130 |
| Entity Type | Individual |
| Full Name | ANNETTE AMBITO SHEPHERD |
| Credential | FNP-C |
| Practice Address |
340 4th Ave Ste 11 Chula Vista CA 91910 |
| Mailing Address |
340 4th Ave Ste 11 Chula Vista CA 91910-3813 |
| Practice Telephone | 6194226158 |
| Mailing Telephone | 6194226158 |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2018-06-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
95008959 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
95008959 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA BOARD OF NURSING NURSE PRACTITIONER CERTIFICATE | 95008959 | 01 |
| Street Address |
340 4TH AVE STE 11 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841225810 | Alfred Shihata | Family Medicine | 340 4th Ave Ste 11, Chula Vista, CA 91910-3813 | 2006-07-11 |
| 1558409334 | Geoffrey P Groom | Specialist | 340 4th Ave Ste 11, Chula Vista, CA 91910-3813 | 2007-02-02 |
| 1487702379 | Jose-daniel Hernandez-rivera | Family Medicine | 340 4th Ave Ste 11, Chula Vista, CA 91910-3813 | 2007-01-08 |
| 1144231028 | Carlos T. De Carvalho, M.d. Inc | Internal Medicine | 340 4th Ave Ste 11, Chula Vista, CA 91910-3813 | 2006-08-10 |
| 1518983543 | Carlos T De Carvalho | Internal Medicine | 340 4th Ave Ste 11, Chula Vista, CA 91910-3813 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194264 | Joshua Maurice Hayden | Dental Hygienist | 678 Thrid Ave, Chula Vista, CA 91910 | 2019-10-02 |
| 1255980504 | Samantha Bernaldo | Dental Hygienist | 668 Third Ave, Chula Vista, CA 91910 | 2019-09-10 |
| 1073179529 | Roshni Kakaiya | Student in an Organized Health Care Education/Training Program | 435 H Street, Cv112, Chula Vista, CA 91910 | 2019-05-09 |
| 1598232506 | Naria Le Mire | Dietitian, Registered | 288 Broadway #141a, Chula Vista, CA 91910 | 2018-10-28 |
| 1730676727 | Pei Chi Chain | Optometrist | 324 F Street., Chula Vista, CA 91910 | 2018-04-16 |
| 1104332741 | Teodoro David Pena | Dentist | 510 Broadway Ste 4-5, Chula Vista, CA 91910 | 2017-12-19 |
| 1538684865 | Camille Cooke | Counselor | 430 F. Street, Chula Vista, CA 91910 | 2017-08-08 |
| 1184146094 | Alexandra Lynn Scovill | Optometrist | Castillejos Eye Institute Medical Group, 342 F Street, Chula Vista, CA 91910 | 2017-07-12 |
| 1396270583 | Tam Trieu | Pharmacist | 555 Broaway Suite 1054, Chula Vista, CA 91910 | 2017-04-25 |
| 1548792815 | Sabrina Owens | Family Medicine | 499 H Street Cv112, Chula Vista, CA 91910 | 2017-03-28 |
| Find all providers in zip 91910 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285243915 | Sandra O Pope | Nurse Practitioner | 1587 Gold Run Rd, Chula Vista, CA 91913-1514 | 2020-07-29 |
| 1558855734 | Heriberto Rivera Beltran | Nurse Practitioner | 2648 Main St Ste A, Chula Vista, CA 91911-4664 | 2018-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738782 | Peninsula Healthcare Center | Nurse Practitioner | 22330 Hawthorne Blvd Ste 208, Torrance, CA 90505-2536 | 2020-10-25 |
| 1710584008 | Venessa Beck | Nurse Practitioner | 903 Cardiff St, San Diego, CA 92114-5019 | 2020-10-08 |
| 1053918094 | Janel Nicole Sanglerat | Nurse Practitioner | 416 Aviation Blvd, Santa Rosa, CA 95403-1032 | 2020-10-02 |
| 1790382760 | Christopher Tran | Nurse Practitioner | 11441 Heacock St Ste F, Moreno Valley, CA 92557-7907 | 2020-10-02 |
| 1487266292 | Mollie Shira Hudson | Nurse Practitioner | 14 Whitmore Pl Apt 15, Oakland, CA 94611-4635 | 2020-08-21 |
| 1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
| 1952912131 | Norman Ivan Kier | Nurse Practitioner | 3834 Edison Ave, Sacramento, CA 95821-2728 | 2020-08-12 |
| 1942811377 | Thanhan Mathews | Nurse Practitioner | 114 W Cameron St Apt B, Hanford, CA 93230-2965 | 2020-08-10 |
| 1972113355 | Marine Mary Kademyan | Nurse Practitioner | 6528 Babcock Ave, North Hollywood, CA 91606 | 2020-07-31 |
| 1245849645 | Shannon Pereira | Nurse Practitioner | 2368 Honeysuckle Way, Hemet, CA 92545-4796 | 2020-07-31 |
| Find all providers with the same taxonomy | ||||
| City | CHULA VISTA |
| Zip Code | 91910 |
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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.