Melissa Shane, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24173 Issued in CA

Practice address

3606 Front St
San Diego, CA 92103-4005

Phone

(619) 204-7712

NPI assigned

Mar 29, 2010

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

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1962727362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23845",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921933845",
            "telephone_number": "619-204-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 FRONT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034005",
            "telephone_number": "619-204-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "24173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arash Shamsinejad Babaki, MD
• Suwanna Shan, CMT
• Shanahan & Associates Inc
• Yuktha Shanavas
• Shane Kelly, D.C., LLC
• Caroline Shang, MD
• Advika Shankar
• Dejanee Shanklin, LCSW
• Amiee Shanks
• Dawn Marie Shanks

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.