Shannon Lacey Yerton

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

658 E Brier Dr
San Bernardino, CA 92408-2880

Phone

(909) 501-0761

NPI assigned

Nov 14, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1831913821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 250",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082875",
            "telephone_number": "909-501-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082880",
            "telephone_number": "909-501-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY YERTON",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Taja Yvette Marie Lacey
• Zava Lacey
• Mary Lacy
• Sebastian Lafo
• Rachael Renee Lagrand

• Adult Companion in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Adult Companion in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.