Active NPI
VA-Shaun Richmond, CADC I
- Addiction (Substance Use Disorder) Counselor
- Victorville, CA
National Provider Identifier
1508575408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CI36721022
- Practice address
- 13333 Palmdale Rd
Victorville, CA 92392-9364 - Phone
- (760) 487-3600
- Fax
- (760) 951-7967
- NPI assigned
- Nov 18, 2022
- 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 | CI36721022 | CA | Primary |
Addresses
Primary practice location
13333 Palmdale Rd
Victorville, CA 92392-9364
Mailing address
13333 Palmdale Rd
Victorville, CA 92392-9364
Phone (760) 487-3600
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 |
|---|---|---|---|
| CI36721022 | 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": "1668729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706054400000",
"number": "1508575408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13333 PALMDALE RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923929364",
"telephone_number": "760-487-3600",
"fax_number": "760-951-7967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13333 PALMDALE RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923929364",
"telephone_number": "760-487-3600",
"fax_number": "760-951-7967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHMOND",
"first_name": "VA-SHAUN",
"credential": "CADC I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-18",
"last_updated": "2024-01-24",
"certification_date": "2024-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CI36721022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.