SEAN MICHAEL WADE (NPI# 1477107415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477107415 |
| Entity Type | Individual |
| Full Name | SEAN MICHAEL WADE |
| Practice Address |
1400 N Norma St Ste 133 Ridgecrest CA 93555-2577 |
| Mailing Address |
1441 N Alford St Ridgecrest CA 93555-8309 |
| Practice Telephone | 7604997406 |
| Mailing Telephone | 7606086672 |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-10-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730442872 | Sean Wade | Student in an Organized Health Care Education/Training Program | Walter Reed National Military Ctr, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600 | 2012-06-22 |
| Street Address |
1400 N NORMA ST STE 133 |
| City | RIDGECREST |
| State | CA |
| Zip Code | 93555-2577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114070760 | Ruthy Michele Smith | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2007-01-18 |
| 1629681267 | Chloe Lynn Walston | Peer Specialist | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-08-24 |
| 1467082768 | Odessa Newman-staples | Peer Specialist | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-01-25 |
| 1033759808 | Vicki Leanne Elliott | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-01-09 |
| 1730729526 | Samantha Hirsch | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-01-09 |
| 1568009173 | Rose M Jones | Licensed Vocational Nurse | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2019-12-02 |
| 1174169726 | Mandy Kress | Social Worker | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2019-11-19 |
| 1578109096 | Whitney Lee Haefele | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2019-11-19 |
| 1255973194 | Deborah Ann Edwards | Counselor | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2019-10-11 |
| 1982245213 | Michael Barbee | Peer Specialist | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2019-10-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321776 | Patrick Joseph Mccammon | Case Manager/Care Coordinator | 1400 N Norma, Ste 127, Ridgecrest, CA 93555 | 2019-11-25 |
| 1780170704 | Krista Mae Sanchez Tizon | Behavior Technician | 123 Grande Way, Suite B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1245726348 | Shinta Desentia Fraya | Behavior Technician | 123 Grande Way Ste B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1780114397 | Darci Turner | Occupational Therapy Assistant | 4309 W Weiman, Ridgecrest, CA 93555 | 2017-06-15 |
| 1700319407 | Telecare Corporation | Clinic/Center | 1141 Chelsea Street, Ridgecrest, CA 93555 | 2017-04-10 |
| 1245776236 | Katherine Gerow | Prevention Professional | 1131 Inyokern Rd, Ridgecrest, CA 93555 | 2017-01-13 |
| 1639552151 | Max Scott Higa | Social Worker | 1400 North Norma Street, Suite 133, Ridgecrest, CA 93555 | 2015-07-01 |
| 1184044703 | Ridgecrest Charter School | Speech-Language Pathologist | 325 S. Downs St., Ridgecrest, CA 93555 | 2014-04-22 |
| 1023366838 | Andrew Whalley | Occupational Therapist | 901 N.heritage Dr., Suite 106, Ridgecrest, CA 93555 | 2012-08-28 |
| 1831453026 | Andrew S Peters | Family Medicine | 1 Administration Circle, Stop 1311, Branch Clinic China Lake, Bldg 1403, Ridgecrest, CA 93555 | 2012-07-02 |
| Find all providers in zip 93555 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681267 | Chloe Lynn Walston | Peer Specialist | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-08-24 |
| 1972115947 | Mariela Germann | Peer Specialist | 1400 N Norma St, Ridgecrest, CA 93555-2575 | 2020-08-20 |
| 1962023499 | Joshua Ray Pierce | Peer Specialist | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2020-05-06 |
| 1467082768 | Odessa Newman-staples | Peer Specialist | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-01-25 |
| 1982245213 | Michael Barbee | Peer Specialist | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2019-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477629 | Karen J Pompa | Peer Specialist | 2605 E Date Palm Paseo Apt 2194, Ontario, CA 91764-4670 | 2020-11-05 |
| 1033710231 | Marcus Kujawa | Peer Specialist | 85 Ramona Expy Ste 13, Perris, CA 92571-7014 | 2020-11-04 |
| 1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
| 1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
| 1497364848 | Marissa Adrianna Garza | Peer Specialist | 1502 Verona Ct, Salinas, CA 93905-2249 | 2020-07-30 |
| 1235765801 | Jill Nina Bierman | Peer Specialist | 25322 Via Piedra Roja, Laguna Niguel, CA 92677-1824 | 2020-03-16 |
| 1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
| 1437783180 | Samuel Guadron Rosales | Peer Specialist | 658 E Brier Dr Ste 250, San Bernardino, CA 92408-2875 | 2020-03-02 |
| 1356973234 | Salina Sheoli Romero | Peer Specialist | 40 West G Street Ste. B, Los Banos, CA 93635 | 2020-02-07 |
| 1578103313 | Charles Winfield Eproson Jr. | Peer Specialist | 4545 Georgetown Pl Ste D, Stockton, CA 95207-6229 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
| City | RIDGECREST |
| Zip Code | 93555 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.