Active NPI
Sheila Kennedy, CAADAC II
- Addiction (Substance Use Disorder) Counselor
- Vallejo, CA
National Provider Identifier
1790149672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- A08660315
- Practice address
- 1628 Broadway St
Vallejo, CA 94590-2405 - Phone
- (707) 649-8300
- Fax
- (707) 649-8302
- NPI assigned
- Apr 7, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | A08660315 | CA | Primary |
Addresses
Primary practice location
1628 Broadway St
Vallejo, CA 94590-2405
Mailing address
1628 Broadway St
Vallejo, CA 94590-2405
Phone (707) 649-8300
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
| License | State | Type | Specialty |
|---|---|---|---|
| A08660315 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459987200000",
"number": "1790149672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1628 BROADWAY ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945902405",
"telephone_number": "707-649-8300",
"fax_number": "707-649-8302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1628 BROADWAY ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945902405",
"telephone_number": "707-649-8300",
"fax_number": "707-649-8302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "SHEILA",
"credential": "CAADAC II",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-07",
"last_updated": "2016-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "A08660315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.