SAMUEL YOUNG SHIN (NPI# 1831654417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831654417 |
| Entity Type | Individual |
| Full Name | SAMUEL YOUNG SHIN |
| Credential | MA |
| Practice Address |
1260 N Dutton Ave Ste 105 Santa Rosa CA 95401-7121 |
| Mailing Address |
Po Box 1064 Sebastopol CA 95473-1064 |
| Practice Telephone | 7075782300 |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326344797 | Samuel Shin | Pharmacist | 2240 Jefferson Davis Hwy, Sanford, NC 27330-8972 | 2011-02-02 |
| 1336586023 | Samuel S Shin | Student in an Organized Health Care Education/Training Program | 600 N Wolfe St, Baltimore, MD 21287 | 2013-06-04 |
| 1669762845 | Samuel Minkee Shin | Radiology | 4950 W Sunset Blvd, Los Angeles, CA 90027-5822 | 2011-04-09 |
| Street Address |
1260 N DUTTON AVE STE 105 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-7121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740538818 | Paula Ploof | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2012-08-21 |
| 1346852720 | Noely Paredes-aguilera | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2020-08-18 |
| 1114549888 | Andrew Tyler Wilson | Marriage & Family Therapist | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2020-05-15 |
| 1124651591 | Anne Njenga | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2020-02-13 |
| 1235774183 | Aubrea Gray | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2019-11-14 |
| 1992347223 | Brandon Lao | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2019-10-08 |
| 1730720731 | Scott Shirlock | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2019-10-01 |
| 1568017168 | Kyra Zona | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2019-08-09 |
| 1982259750 | Pamela Colbert | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2019-08-07 |
| 1902458573 | Rebekah Roberts | Counselor | 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401-7121 | 2019-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1730710260 | Harold Joseph Bahr | Counselor | 1550 N Dutton Ave, Santa Rosa, CA 95401-4601 | 2020-02-03 |
| 1801432398 | William Carroll | Counselor | 1260 N Dutton Ave Ste 185, Santa Rosa, CA 95401-7146 | 2019-11-20 |
| 1497390462 | Emily Sue Hamp | Counselor | 1202 Woodlake Dr, Santa Rosa, CA 95405-9217 | 2019-11-13 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1174005540 | Amal Saeed Ahmed | Counselor | 2908 Bay Village Cir Apt 2108, Santa Rosa, CA 95403-3611 | 2018-09-03 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1992223192 | Jill Mcculloch | Counselor | 300 Stony Point Rd Apt 190, Santa Rosa, CA 95401-5960 | 2017-09-07 |
| 1497299325 | Janice Anne Myers | Counselor | 3746 Oregon Dr, Santa Rosa, CA 95405-7136 | 2016-12-12 |
| 1689128001 | Wakanda Rose | Counselor | 254 Brey Rd, Santa Rosa, CA 95409-5556 | 2016-08-15 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
Please comment or provide details below to improve the information on SAMUEL YOUNG SHIN.
| 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.