Active NPI
Joanne Shelly
- Addiction (Substance Use Disorder) Counselor
- Santa Ana, CA
National Provider Identifier
1386736692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- A022030216
- Practice address
- 910 French St
Santa Ana, CA 92701-3720 - Phone
- (714) 541-2732
- Fax
- (714) 541-2771
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- 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 | A022030216 | CA | Primary |
Addresses
Primary practice location
910 French St
Santa Ana, CA 92701-3720
Mailing address
14632 Dartmouth Cir
Tustin, CA 92780-6606
Phone (714) 544-7980
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 |
|---|---|---|---|
| A022030216 | 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": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623369600000",
"number": "1386736692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14632 DARTMOUTH CIR",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927806606",
"telephone_number": "714-544-7980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 FRENCH ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927013720",
"telephone_number": "714-541-2732",
"fax_number": "714-541-2771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLY",
"first_name": "JOANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2021-06-11",
"certification_date": "2021-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "A022030216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.