Active NPI
Shelly Baesler
- Rehabilitation Counselor
- Pomona, CA
National Provider Identifier
1184758880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- Practice address
- 924 Prock St
Pomona, CA 91768-2054 - Phone
- (909) 620-9715
- NPI assigned
- Mar 15, 2007
- Last updated
- Apr 15, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | NU | Primary |
Addresses
Primary practice location
924 Prock St
Pomona, CA 91768-2054
Mailing address
924 Prock St
Pomona, CA 91768-2054
Phone (909) 620-9715
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C013520 | Other | CA | LADMH STAFF CODE |
| ICAN670 | Other | CA | DMH STAFF CODE |
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": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1184758880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 PROCK ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917682054",
"telephone_number": "909-620-9715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "924 PROCK ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917682054",
"telephone_number": "909-620-9715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAESLER",
"first_name": "SHELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LADMH STAFF CODE",
"identifier": "C013520",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMH STAFF CODE",
"identifier": "ICAN670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.