Travis Shephard

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

10787 Issued in CA

Practice address

8898 Clairemont Mesa Blvd Ste H
San Diego, CA 92123-1127

Phone

(858) 715-1211

NPI assigned

Jun 15, 2020

Sex

Male

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

Practice roles

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.

• Mission Treatment Services, Inc.

  • Methadone Clinic
  • Escondido, CA
  • NPI 1528288347
  NPD (past)
• Mission Treatment Services, Inc.

  • Methadone Clinic
  • San Diego, CA
  • NPI 1750501599
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1568087609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8898 CLAIREMONT MESA BLVD STE H",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231127",
            "telephone_number": "858-715-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8898 CLAIREMONT MESA BLVD STE H",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231127",
            "telephone_number": "858-715-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHARD",
        "first_name": "TRAVIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "10787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Shepard, RN,MSN ED,PMH-BC,PHN
• Melanie Shepard, PA-C
• Sydney Shepard
• Chelsea Shephard
• Karissa Shephard, MA, LAADC
• Jeanette Shepherd
• Jelisa Shepherd, RN
• Joseph Paul Shepherd
• Michael Leenard Shepherd, IDC
• Shannon E Shepherd, M.A., LMFT

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, 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 Jun 15, 2020; 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.