Shelia Green

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1329981118 Issued in CA

Practice address

20331 Flanagan Rd.
Trabuco Canyon, CA 92679

Phone

(818) 582-8832

Fax

(818) 582-8836

NPI assigned

Apr 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Teen Project, Inc.

  • Children's Substance Abuse Rehabilitation Facility
  • Trabuco Canyon, CA
  • NPI 1609345743
  NPD (past)

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1356905293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 SUNLAND BLVD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913523948",
            "telephone_number": "818-582-8832",
            "fax_number": "818-582-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20331 FLANAGAN RD.",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "92679",
            "telephone_number": "818-582-8832",
            "fax_number": "818-582-8836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10425 Painter Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Fe Springs",
            "state": "CA",
            "postal_code": "906703429",
            "country_code": "US",
            "telephone_number": "562-960-2685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SHELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1329981118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianne Gilboy, PA-C
• Jenna Renee Gillies
• Amy Gonzalez
• Briana Christine Gonzalez
• Sarah Goodfellow
• Cyndi Gross, DOULA, CPSS
• Ada Gruita, D.D.S.
• Magdalena Guevara Hernandez, RADT
• Jazel Guillen
• Brenda Joy Haaksma, M.A., CCC-SLP

• All providers in Trabuco Canyon, CA
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.