Shannon Fidler-Price
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bloomington, CA
NPI 1386467041 · NPPES record last updated Nov 1, 2024
Key facts
- NPI
- 1386467041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 18612 Santa Ana Ave
Bloomington, CA 92316-2639 - Phone
- (909) 421-7120
- NPI assigned
- Nov 1, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
18612 Santa Ana Ave
Bloomington, CA 92316-2639
Mailing address
18612 Santa Ana Ave
Bloomington, CA 92316-2639
Phone (909) 421-7120
Other providers in Bloomington, CA
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- Hannah Nicole Esquivel
- Ettie Lee Homes, Inc
- Sara Farnham
- Jose Balibreras Ferman
- Ryan Fisher
- Wayne Fondren
- Nichole Freeman
- Spencer Freitas
- Robert Friddle
All providers in Bloomington, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.