TABITHA SHANNON


Address: 8910 Westhill Rd, Lakeside, CA 92040-3617
Phone: 6198576864

TABITHA SHANNON (NPI# 1881216703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881216703
Entity Type Individual
Full Name TABITHA SHANNON
Credential RN
Practice Address 8910 Westhill Rd
Lakeside
CA 92040-3617
Mailing Address Po Box 7506
San Diego
CA 92167-0506
Practice Telephone 6198576864
Mailing Telephone 6198576864
Enumeration Date 2020-05-13
Last Update Date 2020-05-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WA2000X Registered Nurse
Specialization: Administrator
751974 CA Nursing Service Providers

Office Location

Street Address 8910 WESTHILL RD
City LAKESIDE
State CA
Zip Code 92040-3617

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1912507476 Edna Jean Collins Registered Nurse 15611 Mountain Valley Place, Lakeside, CA 92040 2020-10-26
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1891152369 Kathy Gamboa II Registered Nurse 9636 Caminito Macklin, Lakeside, CA 92040 2016-01-28
1093118176 Thomas Hathorn Substance Abuse Rehabilitation Facility 24352 Featherstone Canyon Rd., Lakeside, CA 92040 2014-10-02
1730361569 The Arc of San Diego Intermediate Care Facility, Mentally Retarded 9075 Creekford Drive, Lakeside, CA 92040 2007-12-04
1134771512 Thais Dinese St Martin Speech-Language Pathologist 12335 Woodside Ave, Lakeside, CA 92040 2019-07-15
1831585561 Genesis Recovery, Inc. Substance Abuse Rehabilitation Facility 24352 Featherstone Canyon Rd., Lakeside, CA 92040 2015-04-09
1699047506 Amy S. Woh Counselor 12064 Woodside Ave Ste 105, Lakeside, CA 92040 2012-02-08
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Taxonomy Information

Taxonomy Code 163WA2000X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Administrator

Taxonomy Definition

Definition to come...

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1770190803 Ma Adelver Quinitio Martin Registered Nurse 5912 Lomond Dr, San Diego, CA 92120-4541 2020-09-23
1285243444 Tracy Travina Bennett Registered Nurse 10762 Wilson Ave, Alta Loma, CA 91737-2436 2020-07-23
1487262879 Sally C Okeke Registered Nurse 15607 Lakewood Blvd Ste A, Paramount, CA 90723-4691 2020-07-21
1700494762 Authorized Home Health Care Inc. Registered Nurse 12410 Burbank Blvd Ste 200, Valley Village, CA 91607-4732 2020-07-16
1306464003 Gloria Quillope Registered Nurse 1061 E Bradley Ave, El Cajon, CA 92021-1232 2020-07-08
1164048682 Marilyn A Wiedemann Registered Nurse 12089 Meriden Ln, San Diego, CA 92128-4339 2020-06-20
1760007991 Petrina J Beugre Registered Nurse 110 Cedar Pointe Loop Apt 1004, San Ramon, CA 94583-4198 2020-06-12
1093335887 Terrevia La Shawn Buck Registered Nurse 1423 W 66th St, Los Angeles, CA 90047-2011 2020-04-21
1770103574 Latonda Knox Registered Nurse 288 W Terrace St, Altadena, CA 91001-4706 2020-04-21
1811523269 Margaret L Martin Registered Nurse 2150 Filbert St, San Francisco, CA 94123-3413 2020-03-18
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Competitor

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City LAKESIDE
Zip Code 92040

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Dataset Information

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.

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