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TYANA SHAW
NPI 1669199642
Internal Medicine - Clinical & Laboratory Immunology in Antioch, CA

Active since October 20, 2022
4965 RIDGEVIEW DR, ANTIOCH, CA 94531(510) 703-2130 Get Directions Write a Review

NPPES record last updated: November 12, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 12, 2022, Oct 21, 2022 (2 updates tracked since 2022).

About Tyana Shaw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYANA SHAW (NPI 1669199642) is an individual clinical & laboratory immunology provider in Antioch, California, licensed in California (207RI0001) and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1669199642
Entity TypeIndividualFemale
Primary Taxonomy207RI0001X
Provider Legal NameTYANA SHAW
Location Address4965 RIDGEVIEW DRAntioch, CA 94531-7757
Mailing Address4965 Ridgeview DrAntioch, CA 94531-7757 · (510) 703-2130
Phone(510) 703-2130
Sole ProprietorNo
Enumeration DateOctober 20, 2022
Last NPPES UpdateNovember 12, 20222 updates tracked since enumeration
NPPES CertifiedNovember 12, 2022
✔ NPI 1669199642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Clinical & Laboratory ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0001X
License✔ Licensed in CA · 207RI0001
Definition
An internal medicine physician who specializes in clinical and laboratory immunology disease management.
4965 RIDGEVIEW DR, Antioch, CA 94531
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyana Shaw's NPI number?

The NPI number for Tyana Shaw is 1669199642. It was assigned to this individual provider in the NPPES registry on October 20, 2022.

Where is Tyana Shaw located?

Tyana Shaw practices at 4965 Ridgeview Dr, Antioch, CA 94531. The listed phone number is (510) 703-2130.

What is Tyana Shaw's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Clinical & Laboratory Immunology, with taxonomy code 207RI0001X.

When was this NPI record last updated?

The NPPES record for Tyana Shaw was last updated on November 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.