Provider Demographics
NPI:1689684615
Name:HAMMER, SHELLEY SHAFER (FNP)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:SHAFER
Last Name:HAMMER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 MISSION AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2328
Mailing Address - Country:US
Mailing Address - Phone:760-479-3900
Mailing Address - Fax:760-753-8175
Practice Address - Street 1:477 N EL CAMINO REAL STE A208
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1329
Practice Address - Country:US
Practice Address - Phone:760-479-3900
Practice Address - Fax:760-753-8175
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP2483363LF0000X
CARN296823163W00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice