SHANNON LEE BEAUCHAMP (NPI# 1902357189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902357189 |
| Entity Type | Individual |
| Full Name | SHANNON LEE BEAUCHAMP |
| Credential | CADCII, ICADC |
| Practice Address |
3101 W Coast Hwy Ste. 200 Newport Beach CA 92663-4001 |
| Mailing Address |
3419 Via Lido Ste. 241 Newport Beach CA 92663-3908 |
| Practice Telephone | 6197159408 |
| Mailing Telephone | 6197159408 |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
A021560216 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NPI | 1790133346 | 01 |
| Street Address |
3101 W COAST HWY STE. 200 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92663-4001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609815026 | Michelle Joanne Matusoff | Psychologist | 3101 W Coast Hwy, Newport Beach, CA 92663-4001 | 2006-06-05 |
| 1699838375 | Steven Dominguez | Internal Medicine | 3101 W Coast Hwy, St 300, Newport Beach, CA 92663-4001 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851905483 | Oasis Anesthesia, Surgical and Medical Group, Inc | Anesthesiology | 496 Old Newpor Blvd., Suite 2, Newport Beach, CA 92663 | 2020-09-01 |
| 1699232801 | Megan Gregor | Surgery | One Hoag Dr., Bldg 41, Ste 122, Newport Beach, CA 92663 | 2019-02-24 |
| 1831621382 | Narges Maududi | Social Worker | 1965 Sherrington Place, K111, Newport Beach, CA 92663 | 2017-04-03 |
| 1225495153 | Mitchelle Giorgi | Physical Therapist | 351 Hospital Road, Suite 007, Newport Beach, CA 92663 | 2016-01-22 |
| 1043620057 | Leslie Mccormack | Speech-Language Pathologist | 270 Cagney Lane #101, Newport Beach, CA 92663 | 2014-04-29 |
| 1265867162 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 4504 Seashore Drive, Newport Beach, CA 92663 | 2013-09-10 |
| 1538504733 | Shawn Zardouz | Psychiatry & Neurology | 3900 W Coast Hwy Ste 390, Newport Beach, CA 92663 | 2013-05-02 |
| 1326330119 | Denise Fortenberry Fortenberry-gratias | Nurse Practitioner | 520 Superior Ave, Suite 350, Newport Beach, CA 92663 | 2011-05-11 |
| 1043500390 | Romit Kumar Kar | Pediatrics | 355 Placentia Ave Ste 301, Newport Beach, CA 92663 | 2011-04-07 |
| 1477858546 | Newport Neurohospitalists | Neurological Surgery | 510 Superior Ave Ste 280, Newport Beach, CA 92663 | 2011-01-20 |
| Find all providers in zip 92663 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700448164 | Audrey Charlotte Hayden | Counselor | 86 Baycrest Ct, Newport Beach, CA 92660-2922 | 2019-07-05 |
| 1437758760 | Jessica Maray Watkins | Counselor | 4120 Birch St Ste 121, Newport Beach, CA 92660-2228 | 2020-10-19 |
| 1811539794 | Aja Chavez | Counselor | 1001 Dove St Ste 215, Newport Beach, CA 92660-2848 | 2019-10-12 |
| 1033696786 | Melissa Hasin | Counselor | 3822 Campus Dr, Newport Beach, CA 92660-2627 | 2018-07-25 |
| 1396259875 | Joshua Lecker | Counselor | 1115 W Balboa Blvd, Newport Beach, CA 92661-1037 | 2017-11-20 |
| 1205362365 | Bryan Vasquez | Counselor | 4540 Campus Dr, Suite #113, Newport Beach, CA 92660 | 2017-05-11 |
| 1760918056 | Christina Merie Milucky | Counselor | 5015 Birch St, Suite 115, Newport Beach, CA 92660-2162 | 2017-05-04 |
| 1104358589 | Holly Kuhn | Counselor | 1115 W Balboa Blvd, Newport Beach, CA 92661-1037 | 2017-04-03 |
| 1215468921 | Michelle Catherine Boudreaux | Counselor | 1601 W Balboa Blvd, Newport Beach, CA 92663-4527 | 2017-03-23 |
| 1881139392 | Carol Weathermon | Counselor | 4000 Birch St, 112, Newport Beach, CA 92660-2211 | 2016-12-20 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92663 |
Please comment or provide details below to improve the information on SHANNON LEE BEAUCHAMP.
| 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.