Shantelle Denise Blackburn

Medicare standing: 1 flag on the record; Listed below.
Plans that list them: Not verified; Not the same as out of network.
Office: 1

On the public record

Medicare does not list them as allowed to order and refer

Offices

1 location

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Shantelle Denise Blackburn’s office at (408) 283-6000 to ask if they take your plan before you enroll.

California Medical Board record

Licence A114520 · Cancelled

Licence status: Cancelled · since 2010 · University of Rochester School of Medicine.

License has been voluntarily canceled, or the license has been expired for at least five years and has not been renewed. No practice is permitted.

Matched on the licence number without its letter prefix; check the name before relying on it.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

Professional record

NPI: 1164192886
Licence: CA 114520California A114520: Cancelled

More record details

Sole proprietor: No
Taxonomy: Federal specialty code 104100000X (104100000X); Federal specialty code 101YM0800X (101YM0800X)
Mailing address: 645 Wool Creek Dr, San Jose, CA, 95112
NPI first listed: 2021-09-14
NPI last updated: 2024-09-03
NPI record certified: 2024-09-03

This is when the NPI record was last certified, not a medical board exam.