Individual provider Active NPI

Dionshae Wishum, SUDCC

  • Addiction (Substance Use Disorder) Counselor
  • Madera, CA
National Provider Identifier
1174871206
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
8636 Issued in CA
Practice address
209 E 7TH St
Madera, CA 93638-3780
Phone
(559) 395-0451
NPI assigned
Aug 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 8636 CA Primary

Addresses

Primary practice location

209 E 7TH St
Madera, CA 93638-3780

Mailing address

209 E 7TH St
Madera, CA 93638-3780
Phone (559) 395-0451

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": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1174871206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E 7TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383780",
            "telephone_number": "559-395-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E 7TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383780",
            "telephone_number": "559-395-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHUM",
        "first_name": "DIONSHAE",
        "name_prefix": "Mr.",
        "credential": "SUDCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-21",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "8636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.