Individual provider Active NPI

Shanea Fawn Sanchez

  • Mental Health Counselor
  • Santa Rosa, CA
National Provider Identifier
1558892745
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
634 Pressley St
Santa Rosa, CA 95404-5526
Phone
(707) 573-6955
NPI assigned
Mar 21, 2017
Last updated
Apr 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

634 Pressley St
Santa Rosa, CA 95404-5526

Mailing address

10920 Ogburn LN
Forestville, CA 95436-9572
Phone (707) 479-1255

Other practice location 1

2403 Professional Dr
Santa Rosa, CA 95403-3007
Phone (707) 571-2233

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

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1558892745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 OGBURN LN",
            "city": "FORESTVILLE",
            "state": "CA",
            "postal_code": "954369572",
            "telephone_number": "707-479-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 PRESSLEY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045526",
            "telephone_number": "707-573-6955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2403 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954033007",
            "country_code": "US",
            "telephone_number": "707-571-2233",
            "fax_number": "707-571-2238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "SHANEA",
        "middle_name": "FAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.