Active NPI
Scott Ray-Shaywn Harrison
- Counselor
- Sacramento, CA
National Provider Identifier
1053673400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 3810 Rosin CT Ste 180
Sacramento, CA 95834 - Phone
- (916) 283-8259
- NPI assigned
- Jun 12, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CA | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
3810 Rosin CT Ste 180
Sacramento, CA 95834
Mailing address
6520 La Cienega Dr
North Highlands, CA 95660-4029
Phone (916) 613-5120
Other practice location 1
4343 Williamsbourgh Dr
Sacramento, CA 95823-2006
Phone (916) 395-3552
Other practice location 2
4343 Williamsbourgh Dr
Sacramento, CA 95823-2006
Phone (916) 395-3552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578009600000",
"number": "1053673400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6520 LA CIENEGA DR",
"city": "NORTH HIGHLANDS",
"state": "CA",
"postal_code": "956604029",
"telephone_number": "916-613-5120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3810 ROSIN CT STE 180",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95834",
"telephone_number": "916-283-8259"
}
],
"practiceLocations": [
{
"address_1": "4343 Williamsbourgh Dr",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958232006",
"country_code": "US",
"telephone_number": "916-395-3552",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4343 Williamsbourgh Dr",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958232006",
"country_code": "US",
"telephone_number": "916-395-3552",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRISON",
"first_name": "SCOTT",
"middle_name": "RAY-SHAYWN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-12",
"last_updated": "2020-01-03",
"certification_date": "2020-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.