Kane, Tara Shanti

Kane, Tara Shanti is an individual health care provider with primary practice located at 1260 Morena Blvd Ste 100 , San Diego CA 92110-3850. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Kane, Tara Shanti can be contacted via phone (619) 398-0355.

Contact Information

Primary practice address
1260 Morena Blvd Ste 100 San Diego CA 92110-3850
Phone: (619) 398-0355
Fax: (619) 398-0350
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X SP017314 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APN.0995403-NP Colorado
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP60794626 Washington
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 400990 New York
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95015265 California

Profile Details

NPI number 1982885414
LBN Legal business name Kane, Tara Shanti
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2007
Last updated Feb 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982885414 NPPES
New York Other 39062A EMPLOYER MEDICARE NUMBER
New York Other 00618162 EMPLOYER MEDICARE NUMBER
New York MEDICAID 911020106 EMPLOYER MEDICARE NUMBER

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