Individual provider Active NPI

Breanna Shepard

  • Addiction (Substance Use Disorder) Counselor
  • Oxnard, CA
National Provider Identifier
1659893063
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
8120 Issued in CA
Practice address
2055 Saviers Rd # a
Oxnard, CA 93033-3608
Phone
(805) 483-2253
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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
Addiction (Substance Use Disorder) Counselor 101YA0400X 8120 CA Primary

Addresses

Primary practice location

2055 Saviers Rd # a
Oxnard, CA 93033-3608

Mailing address

5708 Calle Pamaro
Camarillo, CA 93012-8614
Phone (805) 824-5159

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
8120CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1659893063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 CALLE PAMARO",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128614",
            "telephone_number": "805-824-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 SAVIERS RD # A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930333608",
            "telephone_number": "805-483-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "BREANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "8120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.