ERIC SHAMBOURGER (NPI# 1598253585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598253585 |
| Entity Type | Individual |
| Full Name | ERIC SHAMBOURGER |
| Credential | RN |
| Practice Address |
1904 Richland Ave Ceres CA 95307-4562 |
| Mailing Address |
10680 N Rushmore Dr Fresno CA 93730-0628 |
| Practice Telephone | 2095257444 |
| Mailing Telephone | 5593014084 |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
517583 | CA | Nursing Service Providers |
| Street Address |
1904 RICHLAND AVE |
| City | CERES |
| State | CA |
| Zip Code | 95307-4562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174605067 | Kenneth Edwin Richter Jr. | Psychiatry & Neurology | 1904 Richland Ave, Ceres, CA 95307-4562 | 2006-10-19 |
| 1386252807 | Terren Hinojosa | Social Worker | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-07-21 |
| 1124654447 | James Verma | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-03-18 |
| 1144856576 | Randy Lee Freitas | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-03-17 |
| 1124651294 | Ash Singh | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-02-18 |
| 1922639038 | Sarah Marie Norwood | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-01-28 |
| 1215585716 | Praveena Devi Pal | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-08-28 |
| 1336791052 | Travis Shawn Whitehead | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-07-12 |
| 1487212288 | Sandra Elaine Ainslie | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-06-05 |
| 1699333153 | Cherish Anne Medeiros | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144762022 | Roxanne Mata | Technician | 1904 Richland Ave., Ceres, CA 95307 | 2016-11-09 |
| 1023496379 | Steven Leonard II | Technician, Other | 1904 Richalnd Ave, Ceres, CA 95307 | 2015-05-07 |
| 1942619820 | Thevi Phanthalangsy | Pharmacist | 1421 Coffee Road, Modesto, CA 95307 | 2014-08-05 |
| 1588973937 | Gloria June Coats | Nurse Practitioner | 3641 Mitchell Road, Suite H, Ceres, CA 95307 | 2010-10-04 |
| 1992953236 | John H Meekay | Dentist | 1788 Mitchell Road Suite 105, Ceres, CA 95307 | 2008-08-28 |
| 1316073778 | Donna J Payne | Case Manager/Care Coordinator | 1904 Richland Avenue, Ceres, CA 95307 | 2007-02-27 |
| 1104994656 | Katherine Anne Kucera | Dentist | 3507 Morgan Rd, Ceres, CA 95307 | 2006-12-01 |
| 1073615084 | Tracy S Park | Dentist | 2760 3rd Street, Suite A, Ceres, CA 95307 | 2006-09-01 |
| 1902855588 | Kerry B Evnin Md Inc A Professional Medical Corporation | Family Medicine | 3641 Mitchell Rd, H, Ceres, CA 95307 | 2006-05-09 |
| 1376012559 | David Andrew Kirkpatrick | Technician | 1904 Richland Ave Bldg D, Ceres, CA 95307 | 2018-11-17 |
| Find all providers in zip 95307 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124651294 | Ash Singh | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-02-18 |
| 1215585716 | Praveena Devi Pal | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-08-28 |
| 1124683008 | Joanna Kristine Affolter | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-05-06 |
| 1821552365 | Fanta Mboka | Registered Nurse | 1904 Richland Ave Bldg A, Ceres, CA 95307-4562 | 2019-01-29 |
| 1730650102 | Barbara Loving | Registered Nurse | 1904 Richland Ave Bldg A, Ceres, CA 95307-4562 | 2018-12-11 |
| 1568947141 | Christine Marie Ehrler | Registered Nurse | 1904 Richland Ave Bldg F, Ceres, CA 95307-4562 | 2018-09-28 |
| 1861972804 | Angel Garcia | Registered Nurse | 1904 Richland Ave Bldg A, Ceres, CA 95307-4562 | 2018-08-20 |
| 1053809871 | Navneet Gill | Registered Nurse | 1904 Richland Ave Bldg A, Ceres, CA 95307-4562 | 2018-04-26 |
| 1598279077 | Michele Nielsen | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2017-11-20 |
| 1669983375 | Alysa Maren Sparkman-mendoza | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2017-10-20 |
| Find all providers in CERES | ||||
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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.