SHAWANDA LYNETTE PETTY (NPI# 1942820121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942820121 |
| Entity Type | Individual |
| Full Name | SHAWANDA LYNETTE PETTY |
| Practice Address |
601 Bayonet Cir Marina CA 93933-4600 |
| Mailing Address |
604 Pearl St Monterey CA 93940-3070 |
| Practice Telephone | 8316413000 |
| Mailing Telephone | 8316473000 |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |
| 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 |
601 BAYONET CIR |
| City | MARINA |
| State | CA |
| Zip Code | 93933-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841415296 | Interim, Inc. | Community Based Residential Treatment Facility, Mental Illness | 601 Bayonet Cir, Marina, CA 93933-4600 | 2007-04-13 |
| 1851906986 | Sarah Shine | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2020-09-15 |
| 1346875457 | Andrew Louis Cole Candreva | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2020-03-09 |
| 1407481872 | Matthew D Ferry | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2020-03-06 |
| 1053943449 | Jennifer Elyse Gilmour | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2020-02-04 |
| 1124676838 | Kenia Leyva | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2019-08-27 |
| 1609373885 | Joslyn Marie Scofield | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2018-04-12 |
| 1427569128 | Kendall Claire Snel | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2017-10-20 |
| 1588115604 | Pablo Alvarez | Counselor | 601 Bayonet Cir, Marina, CA 93933 | 2016-10-24 |
| 1528499027 | David Conow | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2013-12-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803012 | Caterina Poehner | Social Worker | 617 Bayonet Cirle, Marina, CA 93933 | 2020-08-28 |
| 1972036499 | Stephanie Blalock | Counselor | 617 Bayonet Circle, Marina, CA 93933 | 2017-04-11 |
| 1588110340 | Monique Theaker | Counselor | 299b Twelfth Street, Marina, CA 93933 | 2016-08-31 |
| 1053709220 | Mehry Khazan | Marriage & Family Therapist | 299 Twelfth Street, Marina, CA 93933 | 2014-12-22 |
| 1306241476 | Tiffany Avery | Counselor | 299 12th St Ste B, Marina, CA 93933 | 2014-10-30 |
| 1881037141 | Marilyn Anderson | Counselor | 3043 Macarthur Dr, Marina, CA 93933 | 2013-04-16 |
| 1669744280 | Leslie Penley | Dentist | 3154 Deforest Rd. Suitea, Marina, CA 93933 | 2012-01-27 |
| 1215221510 | Janet Hernandez Barajas | Social Worker | 299a 12th Street, Marina, CA 93933 | 2011-06-03 |
| 1538302740 | Sonia Cortes | Counselor | 613 Bayonet Cir., Marina, CA 93933 | 2009-04-17 |
| 1144476003 | Carolina Cortez | Counselor | 2982 Bayonet Ct, Marina, CA 93933 | 2008-08-12 |
| Find all providers in zip 93933 | ||||
| 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 |
|---|---|---|---|---|
| 1407305246 | Ashley Robinson | Counselor | 530 Wilson Ct, Marina, CA 93933-4627 | 2016-09-21 |
| 1588110340 | Monique Theaker | Counselor | 299b Twelfth Street, Marina, CA 93933 | 2016-08-31 |
| 1538302740 | Sonia Cortes | Counselor | 613 Bayonet Cir., Marina, CA 93933 | 2009-04-17 |
| 1316184369 | David Ray Smith | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2009-01-13 |
| 1851906986 | Sarah Shine | Counselor | 601 Bayonet Cir, Marina, CA 93933-4600 | 2020-09-15 |
| 1215578182 | David Petrini | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2019-10-02 |
| 1124676069 | Karina Ramires | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2019-09-03 |
| 1467953661 | Angela Garcia | Counselor | 299 12th St Ste B, Marina, CA 93933-6003 | 2018-02-22 |
| 1275056178 | David Pirochta | Counselor | 617 Bayonet Cir, Marina, CA 93933-4600 | 2017-07-23 |
| 1588115604 | Pablo Alvarez | Counselor | 601 Bayonet Cir, Marina, CA 93933 | 2016-10-24 |
| Find all providers in MARINA | ||||
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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.