Individual provider Active NPI

Shaye Lynn Costanza

  • Counselor
  • Grass Valley, CA
National Provider Identifier
1194485169
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
760 S Auburn St Ste C2
Grass Valley, CA 95945-4318
Phone
(530) 265-5811
NPI assigned
Dec 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

760 S Auburn St Ste C2
Grass Valley, CA 95945-4318

Mailing address

760 S Auburn St Ste C2
Grass Valley, CA 95945-4318
Phone (530) 265-5811

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": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1194485169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 S AUBURN ST STE C2",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454318",
            "telephone_number": "530-265-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 S AUBURN ST STE C2",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454318",
            "telephone_number": "530-265-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZA",
        "first_name": "SHAYE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.