SHANNON NICOLE VERKETIS RADT1 R1454820122 NPI 1962159889

NPI Information

NPI: 1962159889
Provider Name: SHANNON NICOLE VERKETIS, RADT1 R1454820122
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
419 PENNSYLVANIA ST
VALLEJO, CA
ZIP 94590
Phone: (707) 643-2715
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Shannon Nicole Verketis, RADT1 R1454820122 is an addiction (substance use disorder) counselor in Vallejo, CA. Shannon Nicole Verketis, RADT1 R1454820122 NPI is 1962159889. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

419 PENNSYLVANIA ST
VALLEJO, CA
ZIP 94590-933
Phone: (707) 643-2715
Fax: (707) 643-8536

The enumeration date for this NPI number is 3/10/2022 and was last updated on 3/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	R1454820122	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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