Shannon Denise Reilly, CAS

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

324500000X Issued in CA

Practice address

5494 Pony Express Trail
Pollock Pines, CA 95726

Phone

(530) 644-3758

Fax

(530) 644-3782

NPI assigned

Mar 30, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progress House Inc.

  • Substance Abuse Rehabilitation Facility
  • Pollock Pines, CA
  • NPI 1417112228
  NPD (past)

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1891937306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 586",
            "city": "CAMINO",
            "state": "CA",
            "postal_code": "957090586",
            "telephone_number": "530-644-3758",
            "fax_number": "530-644-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5494 PONY EXPRESS TRAIL",
            "city": "POLLOCK PINES",
            "state": "CA",
            "postal_code": "95726",
            "telephone_number": "530-644-3758",
            "fax_number": "530-644-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SHANNON",
        "middle_name": "DENISE",
        "credential": "CAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "324500000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pollock Pines Elementary
• Positive Behavioral Services, LLC
• Progress House Inc.
• Rae Medical
• Angela Reading, LCSW
• Joanne Richerson, PHARMD
• Maureen Robertson
• America Ladybird Robicheau
• Lindsey Rogers, CD(DONA)
• Theresa Joanne Russell, CADC-11

• Substance Abuse Rehabilitation Facility in Pollock Pines, CA
• Providers in Pollock Pines, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.