Anthony Mason Shepherd Sr., PEER SUPPORT

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

11434 B Ave Ste 200
Auburn, CA 95603-2603

Phone

(530) 889-7247

Fax

(530) 889-7293

NPI assigned

Sep 19, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1758240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1174495089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11434 B AVE STE 200",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032603",
            "telephone_number": "530-889-7247",
            "fax_number": "530-889-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11434 B AVE STE 200",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032603",
            "telephone_number": "530-889-7247",
            "fax_number": "530-889-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "ANTHONY",
        "middle_name": "MASON",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PEER SUPPORT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-19",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peer Specialist in Auburn, CA
• Providers in Auburn, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.