Provider Demographics
NPI:1942436811
Name:JOAQUIN, SHAWNA LYNN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:LYNN
Last Name:JOAQUIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2121 YGNACIO VALLEY RD
Mailing Address - Street 2:STE E101
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:925-945-6600
Mailing Address - Fax:925-945-7842
Practice Address - Street 1:2121 YGNACIO VALLEY RD
Practice Address - Street 2:STE E101
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-945-6600
Practice Address - Fax:925-945-7842
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP19467363LW0102X, 363LX0001X, 363L00000X
CA593213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse