Individual provider Active NPI

Kathryn Jocelyn Nuss, CASII, NCACI

  • Addiction (Substance Use Disorder) Counselor
  • Shasta Lake, CA
National Provider Identifier
1730449620
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
03-035422 Issued in CA
Practice address
5010 Shasta Dam Blvd
Shasta Lake, CA 96019-9406
Phone
(530) 275-1076
Fax
(530) 275-1076
NPI assigned
May 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2012

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 03-035422 CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 015233 CA

Addresses

Primary practice location

5010 Shasta Dam Blvd
Shasta Lake, CA 96019-9406

Mailing address

5010 Shasta Dam Blvd
Shasta Lake, CA 96019-9406
Phone (530) 275-1076

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
015233CAMDAddiction (Substance Use Disorder) Counselor
03-035422CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1730449620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 SHASTA DAM BLVD",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199406",
            "telephone_number": "530-275-1076",
            "fax_number": "530-275-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 SHASTA DAM BLVD",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199406",
            "telephone_number": "530-275-1076",
            "fax_number": "530-275-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSS",
        "first_name": "KATHRYN",
        "middle_name": "JOCELYN",
        "name_prefix": "Mrs.",
        "credential": "CASII, NCACI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "03-035422",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "015233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shasta Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.