Provider Demographics
NPI:1912314287
Name:WARD, SHAWNA MAUREEN (NP)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MAUREEN
Last Name:WARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:
Other - Last Name:WINANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 THE EMBARCADERO STE 1500
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-5200
Mailing Address - Country:US
Mailing Address - Phone:510-428-3302
Mailing Address - Fax:510-597-7199
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3302
Practice Address - Fax:510-597-7199
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH354698163WP0200X
CA825249163WP0200X
CA95020484363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics