Shawna Phillips, SAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11702 Issued in CA

Practice address

823 E Orangeburg Ave
Modesto, CA 95350-4619

Phone

(209) 527-9797

Fax

(209) 527-9825

NPI assigned

Sep 8, 2021

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

Locations

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.

• Lost Dreams Awaken

  • Substance Abuse Rehabilitation Facility
  • Modesto, CA
  • NPI 1629747142

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1457020901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504619",
            "telephone_number": "209-527-9797",
            "fax_number": "209-527-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504619",
            "telephone_number": "209-527-9797",
            "fax_number": "209-527-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SHAWNA",
        "credential": "SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "11702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Ha Dental Corporation
• Erendira Ines Phillips
• John Mark Phillips, RN
• Khyla LJ Phillips
• Linda Sue Phillips, PA-C
• Gary W Phipps
• Amanda Phitsamay
• Jasmine Phol
• Physicians Surgery Center of Modesto LLC
• Nicole Picciotto, MD

• Addiction (Substance Use Disorder) Counselor in Modesto, CA
• Providers in Modesto, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.

Verify at the official NPI Registry.