Individual provider Active NPI

Shanna Rae Collaso, BACHELOR OF SCIENCE

  • Addiction (Substance Use Disorder) Counselor
  • Escondido, CA
National Provider Identifier
1578718912
Registry record updated Feb 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
BACHELOR OF SCIENCE Issued in NV
Practice address
130 S Fig St
Escondido, CA 92025-4401
Phone
(760) 741-5098
NPI assigned
Nov 26, 2008
Last updated
Feb 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X BACHELOR OF SCIENCE NV Primary

Addresses

Primary practice location

130 S Fig St
Escondido, CA 92025-4401

Mailing address

603 Seagaze Dr # 289
Oceanside, CA 92054-3005
Phone (702) 321-8052

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

LicenseStateTypeSpecialty
BACHELOR OF SCIENCENVMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235606400000",
    "number": "1578718912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 SEAGAZE DR # 289",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920543005",
            "telephone_number": "702-321-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S FIG ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254401",
            "telephone_number": "760-741-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLASO",
        "first_name": "SHANNA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "BACHELOR OF SCIENCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-26",
        "last_updated": "2009-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "BACHELOR OF SCIENCE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; 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.