NPIMap

Organization Active NPI

Shamanic Living Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Diamond Springs, CA
National Provider Identifier
1407346513
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SHAMANIC LIVING CENTER
Doing business as
Recovery In Action
Practice address
484 Pleasant Valley Road Ste 4
Diamond Springs, CA 95619-9101
Phone
(530) 344-7633
Fax
(530) 497-5202
NPI assigned
May 14, 2018
Organization subpart
Yes
Parent organization
SHAMANIC LIVING CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Authorized official

Name
Lisa Mastropieri
Title
Administrator
Phone
(530) 344-7633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

484 Pleasant Valley Road Ste 4
Diamond Springs, CA 95619-9101

Mailing address

484 Pleasant Valley Road Ste 4
Diamond Springs, CA 95619-9101
Phone (530) 344-7633

Other names 1

  • Recovery In Action Doing business as

National Provider Directory

National Provider Directory
Part of
Shamanic Living Center

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550188800000",
    "number": "1407346513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 PLEASANT VALLEY ROAD STE 4",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199101",
            "telephone_number": "530-344-7633",
            "fax_number": "530-497-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 PLEASANT VALLEY ROAD STE 4",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199101",
            "telephone_number": "530-344-7633",
            "fax_number": "530-497-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMANIC LIVING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHAMANIC LIVING CENTER",
        "enumeration_date": "2018-05-14",
        "last_updated": "2019-02-15",
        "status": "A",
        "authorized_official_last_name": "MASTROPIERI",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "530-344-7633"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recovery In Action",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Diamond Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.