Provider Demographics
NPI:1063288843
Name:WILLIAMS, SHANIA (NREMT)
Entity type:Individual
Prefix:
First Name:SHANIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9421 ARMSTRONG DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94603-3046
Mailing Address - Country:US
Mailing Address - Phone:510-375-8879
Mailing Address - Fax:
Practice Address - Street 1:9421 ARMSTRONG DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94603-3046
Practice Address - Country:US
Practice Address - Phone:510-375-8879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE181031146M00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate