Shelly Denise Booker

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1235 McHenry Ave Ste a&B
Modesto, CA 95350-5370

Phone

(209) 527-4597

Fax

(209) 527-4599

NPI assigned

Nov 20, 2006

Last updated

Mar 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Shelly Denise Cantu-Ramirez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Banning, CA
  • NPI 1376293407
  NPD (past)
• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Canoga Park, CA
  • NPI 1831601764
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1972677839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 MCHENRY AVE STE A&B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505373",
            "telephone_number": "209-527-4597",
            "fax_number": "209-527-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 MCHENRY AVE STE A&B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505370",
            "telephone_number": "209-527-4597",
            "fax_number": "209-527-4599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1278 Johnson Avenue",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "93401",
            "country_code": "US",
            "telephone_number": "805-781-4700",
            "fax_number": "805-781-4145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "SHELLY",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "CANTU-RAMIREZ",
            "middle_name": "DENISE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffery Boney
• Ann Lucille Bonfiglio
• James Bonieja
• Camera Bonsack, CST II
• Esperanza Luciana Booher
• David Ronald Boone, PA-C
• Katherine Boone
• Makayla Boone
• Anita M Boonstra, OT
• Samantha Booth

• Student in an Organized Health Care Education/Training Program in Modesto, CA
• Providers in Modesto, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.