Active NPI
Charles Nathaniel Shedrick, C.A.T.S.
- Addiction (Substance Use Disorder) Counselor
- Altadena, CA
National Provider Identifier
1215060009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 030806
- Practice address
- 3085 Ridgeview Dr
Altadena, CA 91001-4527 - Phone
- (626) 791-0831
- Fax
- (626) 791-1592
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 030806 | CA | Primary |
Addresses
Primary practice location
3085 Ridgeview Dr
Altadena, CA 91001-4527
Mailing address
909 N Azusa Ave
Azusa, CA 91702-2408
Phone (818) 207-5808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030806 | Other | CA | CATC CREDENTIAL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030806 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299542400000",
"number": "1215060009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 N AZUSA AVE",
"city": "AZUSA",
"state": "CA",
"postal_code": "917022408",
"telephone_number": "818-207-5808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3085 RIDGEVIEW DR",
"city": "ALTADENA",
"state": "CA",
"postal_code": "910014527",
"telephone_number": "626-791-0831",
"fax_number": "626-791-1592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEDRICK",
"first_name": "CHARLES",
"middle_name": "NATHANIEL",
"name_prefix": "Mr.",
"credential": "C.A.T.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2011-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "030806",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CATC CREDENTIAL",
"identifier": "030806",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.