Individual provider Active NPI

Colton Ryan Fiske, RADT I

  • Addiction (Substance Use Disorder) Counselor
  • Grass Valley, CA
National Provider Identifier
1952106304
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1498650223
Practice address
159 Brentwood Dr
Grass Valley, CA 95945-5703
Phone
(530) 273-9541
NPI assigned
Feb 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1498650223 Primary

Addresses

Primary practice location

159 Brentwood Dr
Grass Valley, CA 95945-5703

Mailing address

406 Sunrise Ave Ste 105
Roseville, CA 95661-4145
Phone (530) 273-9541

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

Practice roles

OrganizationSpecialtyStatusNew patients
Granite Wellness Centers PastSince Jun 29, 2025 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1952106304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SUNRISE AVE STE 105",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614145",
            "telephone_number": "530-273-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BRENTWOOD DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455703",
            "telephone_number": "530-273-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISKE",
        "first_name": "COLTON",
        "middle_name": "RYAN",
        "credential": "RADT I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "R1498650223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.