Shaddy Saba, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

108354 Issued in CA

Practice address

30893 E Sunset Dr S
Redlands, CA 92373-7492

Phone

(951) 236-3250

NPI assigned

Aug 1, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1619455656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30893 E SUNSET DR S",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30893 E SUNSET DR S",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737492",
            "telephone_number": "951-236-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABA",
        "first_name": "SHADDY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW133735",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity Penaloza Russell, MD
• Judith Russell, LCSW
• Saliar T Rustem, M.D.
• Denise Erica Ruvalcaba, RN
• Saad Sagman, DDS, Inc
• Crystal Marie Sabas, RN
• Gerard Sabate, D.D.S
• Bler B. Sacay
• Norie Sadjadi, MD
• Safe & Secure Non Emergency Medical Transportation

• Clinical Social Worker in Redlands, CA
• Providers in Redlands, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.