Provider Demographics
NPI:1790474575
Name:PARRISHER, SHAUN DAVID (RN)
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:DAVID
Last Name:PARRISHER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2398 FERNWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5638
Mailing Address - Country:US
Mailing Address - Phone:925-788-1441
Mailing Address - Fax:
Practice Address - Street 1:5201 DEER VALLEY RD STE 1D
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-7430
Practice Address - Country:US
Practice Address - Phone:925-788-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA798832163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty