Shontinese Huey, PSY.D

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

21817 Issued in CA

Practice address

2291 W March LN Ste E-101
Stockton, CA 95207-6652

Phone

(209) 451-9475

Fax

(209) 451-9475

NPI assigned

May 22, 2010

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)

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.

• Lighthouse Psychological Services... a Beacon of Light

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1518401900
  NPD Authorized official

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

{
    "created_epoch": "1274486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1538488119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 556",
            "city": "SALIDA",
            "state": "CA",
            "postal_code": "953680556",
            "telephone_number": "209-451-9475",
            "fax_number": "209-451-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 W MARCH LN STE E-101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076652",
            "telephone_number": "209-451-9475",
            "fax_number": "209-451-9475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2291 W March Ln",
            "address_2": "Ste. D-199",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952076652",
            "country_code": "US",
            "telephone_number": "209-451-1014",
            "fax_number": "209-451-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUEY",
        "first_name": "SHONTINESE",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "21817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Jade Huerta
• Iskally Huerta
• Karina Huerta
• Paul Julian Huerta Jr.
• Sydney Laurel Huestis
• Idella Huff
• Jarred Joseph Huff
• David Duane Hufsteler
• Judith Rose Huggins
• Nicholas J Huggins Jr.

• Clinical Child & Adolescent Psychologist in Stockton, CA
• Providers in Stockton, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.