Katherine Elizabeth Evelyn Shore

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1460010322 Issued in CA

Practice address

8400 Fair Oaks Blvd
Carmichael, CA 95608-2502

Phone

(916) 944-3920

NPI assigned

Mar 14, 2022

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1477201044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 ARGO WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958205739",
            "telephone_number": "916-719-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082502",
            "telephone_number": "916-944-3920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5311 Argo Way",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958205739",
            "country_code": "US",
            "telephone_number": "916-719-2071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORE",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH EVELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1460010322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Carmichael, CA
• Providers in Carmichael, 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 Feb 14, 2024; 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.