SHANE FULLER (NPI# 1497112114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497112114 |
| Entity Type | Individual |
| Full Name | SHANE FULLER |
| Practice Address |
11255 Mann Rd Wilton CA 95693-9712 |
| Practice Telephone | 9166060027 |
| Mailing Telephone | 9166060027 |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2016-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326450867 | Shane Alan Fuller | Dentist | 8788 Jamacha Rd, Spring Valley, CA 91977-4035 | 2014-06-02 |
| Street Address |
11255 MANN RD |
| City | WILTON |
| State | CA |
| Zip Code | 95693-9712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568004687 | Jeremy Adam Yee | Physical Therapist | 9479 Sidesaddle Dr, Wilton, CA 95693-9241 | 2019-10-09 |
| 1962850495 | Inaya Mohamad Hazime | Pharmacist | 9321 Starting Gate Ct, Wilton, CA 95693-9249 | 2016-05-25 |
| 1184065328 | Amber Lee Garza | Marriage & Family Therapist | 11080 Jeff Brian Ln Ste A120, Wilton, CA 95693-9514 | 2013-07-16 |
| 1245523802 | Sarandar Kour Newell | Registered Nurse | 13373 Orange Rd, Wilton, CA 95693-9664 | 2011-05-16 |
| 1164029849 | Montay Mcdaniel | Counselor | 9586 Sunflower Rd, Wilton, CA 95693-9739 | 2020-10-06 |
| 1437618915 | Wilton Fire Protection District | Ambulance | 9800 Dillard Rd, Wilton, CA 95693-9759 | 2019-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029849 | Montay Mcdaniel | Counselor | 9586 Sunflower Rd, Wilton, CA 95693-9739 | 2020-10-06 |
| 1962009050 | Taylor Pechtel | Student in an Organized Health Care Education/Training Program | 23 Craw Ln, Wilton, NY 12831-1671 | 2020-10-02 |
| 1669088100 | Andrea Blake | Occupational Therapist | 17 Woodchuck Ln, Wilton, CT 06897-3427 | 2020-09-21 |
| 1265043053 | Brittany Buckley | Physical Therapist | 396 Danbury Rd Unit 5, Wilton, CT 06897-2024 | 2020-08-14 |
| 1902415953 | Simmi S Narula | Registered Nurse | 1 Brenner Rd, Wilton, CT 06897-4701 | 2020-07-27 |
| 1265041123 | Eric Dwight English | Registered Nurse | 531 Belden Hill Rd, Wilton, CT 06897-4222 | 2020-07-27 |
| 1134740566 | Interventional Orthopedics Ct, P.c | Physical Medicine & Rehabilitation | 195 Danbury Rd Ste B200, Wilton, CT 06897-6009 | 2020-04-27 |
| 1104445964 | Madeleine Hope Kamp | Student in an Organized Health Care Education/Training Program | 167 Linden Tree Rd, Wilton, CT 06897-1617 | 2020-04-13 |
| 1003443813 | Megan Sass | Psychologist | 57 School Rd, Wilton, NH 03086-5156 | 2020-03-24 |
| 1730713926 | Sara Jackson | Behavior Technician | 15 Seagroves St, Wilton, NH 03086 | 2020-02-26 |
| Find all providers in WILTON | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922583236 | Martin Brault | Counselor | 6 Hollyhock Rd Fl 2, Wilton, CT 06897-4414 | 2018-10-02 |
| 1598999781 | Kristin Verbeck | Counselor | 545 Depot St # 2r, Pob 1216, Wilton, ME 04294-6605 | 2009-05-04 |
| 1104348176 | Carolee Anne Paruta | Counselor | 372 Danbury Rd, Wilton, CT 06897-2523 | 2017-07-12 |
| 1063698546 | Kimberly A Cognato | Counselor | 372 Danbury Rd, Wilton, CT 06897-2523 | 2008-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1538760871 | Ky Washington | Counselor | 1625 Sweetwater Rd # C1, National City, CA 91950-7647 | 2020-11-03 |
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1548869266 | Yama Totakhail | Counselor | 915 Bryant St # 94103, San Francisco, CA 94103-4514 | 2020-10-23 |
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1285233155 | Alaric Fairchild | Counselor | 1400 N Johnson Ave Ste 1011400n, El Cajon, CA 92020-1650 | 2020-10-21 |
| 1487253571 | Roxanne Rene Coito | Counselor | 1919 Apple St # D, Oceanside, CA 92054-4425 | 2020-10-20 |
| 1255939732 | Diana Palencia | Counselor | 44459 10th St W, Lancaster, CA 93534-3324 | 2020-10-15 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| Find all providers with the same taxonomy | ||||
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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.