Individual provider Active NPI

Shannon Danile Wight, CAS-CADC

  • Rehabilitation Practitioner
  • Merced, CA
National Provider Identifier
1215222823
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
C13051214 Issued in CA
Practice address
301 E 13TH St
Merced, CA 95341-6211
Phone
(209) 381-6850
Fax
(209) 385-3174
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 02-090691 CA
Rehabilitation Practitioner 225400000X C13051214 CA Primary

Addresses

Primary practice location

301 E 13TH St
Merced, CA 95341-6211

Mailing address

PO Box 2087
Merced, CA 95344-0087
Phone (209) 381-6850

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

LicenseStateTypeSpecialty
02-090691CAMDAddiction (Substance Use Disorder) Counselor
C13051214CAMDRehabilitation Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1215222823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953440087",
            "telephone_number": "209-381-6850",
            "fax_number": "209-385-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 13TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416211",
            "telephone_number": "209-381-6850",
            "fax_number": "209-385-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGHT",
        "first_name": "SHANNON",
        "middle_name": "DANILE",
        "name_prefix": "Mrs.",
        "credential": "CAS-CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "02-090691",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "C13051214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.