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NPI Code Detail

MEDICARE: MRS. SHAWNA MICHELE JILES

MEDICARE: MRS. SHAWNA MICHELE JILES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1144456351
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHAWNA MICHELE JILES
Provider Business Mailing Address
First Line : 5850 GRANITE PKWY STE 600
Second Line :
City : PLANO
State : TX
Zip : 75024-6753
Country : US
Telephone Number : 818-346-2345
Fax Number : 916-394-1010
Provider Business Practice Location Address
First Line : 6939 SUNRISE BLVD STE 107
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-3153
Country : US
Telephone Number : 916-547-5908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2009
Last Update Date : 11/03/2022

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Directions to “ MRS. SHAWNA MICHELE JILES ” Practice Location

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