SHANNON DIAZ (NPI# 1740673441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740673441 |
| Entity Type | Individual |
| Full Name | SHANNON DIAZ |
| Practice Address |
1108 S El Camino Real San Mateo CA 94402-2804 |
| Mailing Address |
1500 Franklin St San Francisco CA 94109-4523 |
| Practice Telephone | 6504580026 |
| Practice Fax Number | 6504580027 |
| Mailing Telephone | 4154747310 |
| Mailing Fax Number | 6504580027 |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1108 S EL CAMINO REAL |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720204506 | David Dean Johnson | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2007-04-18 |
| 1548876337 | Jenae Aesha Richardson | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2020-09-17 |
| 1982148557 | Michael Krechevsky | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-12-15 |
| 1992248884 | Cheng Hsu | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-11-23 |
| 1215485487 | Philip Hershon | Peer Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-09-16 |
| 1104283167 | Bryan Robert Milonja | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2016-01-21 |
| 1669855730 | Patrick Kerwin | Specialist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2015-07-07 |
| 1063831337 | Sarah Schaafsma | Marriage & Family Therapist | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2014-04-15 |
| 1174952378 | Mary Brennan | Counselor | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2013-11-07 |
| 1093142309 | Nga Ly | Nurse Practitioner | 1108 S El Camino Real, San Mateo, CA 94402-2804 | 2013-10-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
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| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134686991 | Connie Markoff | Counselor | 3827 Fernwood St, San Mateo, CA 94403 | 2019-02-27 |
| 1114454402 | Ligia S Hernandez | Counselor | 126 W 25th Ave Unit 202, San Mateo, CA 94403-2208 | 2017-05-17 |
| 1669928214 | Jacqueline Alexandria Santana | Counselor | 126 W 25th Ave Ste 200, San Mateo, CA 94403-2208 | 2016-09-01 |
| 1497196984 | William Charles Cotter | Counselor | 113 Valley View Dr, San Mateo, FL 32187-2100 | 2013-07-11 |
| 1083925804 | Michael Seligson | Counselor | 3 Waters Park Dr Ste 200, San Mateo, CA 94403-1149 | 2010-06-25 |
| 1740511807 | Adrienne Gatan | Counselor | 1720 S Amphlett Blvd Ste 110, San Mateo, CA 94402-2710 | 2010-01-28 |
| 1013145291 | Marcos H. Chacon Jr. | Counselor | 2001 Winward Way Ste 200, San Mateo, CA 94404-4019 | 2009-06-26 |
| 1306002050 | Peggy Chingin Kwok | Counselor | 1950 Alameda De La Pulgas, San Mateo, CA 94403 | 2008-08-01 |
| 1821261785 | Jessica Escobedo | Counselor | 1720 S Amphlett Blvd Ste 123, San Mateo, CA 94402-2710 | 2008-04-10 |
| 1962615641 | Lydia Jones | Counselor | 136 N. San Mateo Drive, Suite 101, San Mateo, CA 94401 | 2007-05-08 |
| Find all providers in SAN MATEO | ||||
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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.