Provider Demographics
NPI:1720046287
Name:PARISE, SHAWNDRA CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWNDRA
Middle Name:CATHERINE
Last Name:PARISE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2301 CAMINO RAMON
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4440
Mailing Address - Country:US
Mailing Address - Phone:925-866-1005
Mailing Address - Fax:925-866-1006
Practice Address - Street 1:2301 CAMINO RAMON
Practice Address - Street 2:SUITE 180
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4440
Practice Address - Country:US
Practice Address - Phone:925-866-1005
Practice Address - Fax:925-866-1006
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-12-20
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Provider Licenses
StateLicense IDTaxonomies
CAA87276207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI68469Medicare UPIN