Provider Demographics
NPI:1104038827
Name:SHIOMI, SHAWNA E (RN)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:E
Last Name:SHIOMI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37220 AVENUE 12 1/4
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8652
Mailing Address - Country:US
Mailing Address - Phone:559-240-4114
Mailing Address - Fax:
Practice Address - Street 1:5727 N FRESNO ST
Practice Address - Street 2:PPMM FAMILY FIRST
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-446-1515
Practice Address - Fax:559-446-1273
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN696481163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse