Active NPI
Andrew Tyson Shaffner, MA SLP-CCC
- Speech-Language Pathologist
- Chico, CA
National Provider Identifier
1609024322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP15424
- Practice address
- 1 Glenshire LN
Chico, CA 95973-1072 - Phone
- (530) 894-1022
- NPI assigned
- Sep 5, 2008
- Last updated
- Apr 23, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP15424 | CA | Primary |
Addresses
Primary practice location
1 Glenshire LN
Chico, CA 95973-1072
Mailing address
1840 Mosure LN
Paradise, CA 95969-6016
Phone (530) 514-0546
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15424 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| SP15424 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524441600000",
"number": "1609024322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 MOSURE LN",
"city": "PARADISE",
"state": "CA",
"postal_code": "959696016",
"telephone_number": "530-514-0546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GLENSHIRE LN",
"city": "CHICO",
"state": "CA",
"postal_code": "959731072",
"telephone_number": "530-894-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFNER",
"first_name": "ANDREW",
"middle_name": "TYSON",
"name_prefix": "Mr.",
"credential": "MA SLP-CCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-05",
"last_updated": "2018-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP15424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.