Colleen Callahan, CADC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A066880825 Issued in CA

Practice address

2781 W Ramsey St Ste 3&4
Banning, CA 92220-3700

Phone

(951) 417-6612

NPI assigned

Nov 13, 2018

Last updated

Mar 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Banning, CA
  • NPI 1376293407
  NPD (past)
• Whiteside Manor, Inc.

  • Substance Abuse Rehabilitation Facility
  • Riverside, CA
  • NPI 1376081323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1104394709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3286 E GUASTI RD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 W RAMSEY ST STE 3&4",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203700",
            "telephone_number": "951-417-6612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11646 Encanto Ln",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923249218",
            "country_code": "US",
            "telephone_number": "909-222-4073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "COLLEEN",
        "credential": "CADC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A066880825",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1239211216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darren Tempest Burtenshaw
• Jackie Bustamante
• California Addiction Treatment Center LLC (California Highlands Addiction Treatment)
• California Em-I Medical Services a Medical Corporation
• California Neonatology Services a Medical Corporation
• Craig F Callam, APRN, FNP-BC
• Crystal Capitan
• Diana Cardenas, PPS
• Laura Cardenas
• Samara Yael Cardona Espinoza

• Addiction (Substance Use Disorder) Counselor in Banning, CA
• Providers in Banning, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.