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NPI Code Detail

MEDICARE: SHARLENE WHITTEY CADC 1

MEDICARE: SHARLENE WHITTEY CADC 1
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
1101Y00000XCounselor
2171M00000XCase Manager/Care Coordinator
3101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11740568575OTHERCACOUNSELOR

General Provider Information

NPI Number : 1740568575
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARLENE WHITTEY CADC 1
Provider Business Mailing Address
First Line : 1260 E ARROW HWY
Second Line :
City : UPLAND
State : CA
Zip : 91786-4982
Country : US
Telephone Number : 909-932-1069
Fax Number : 909-981-2031
Provider Business Practice Location Address
First Line : 1260 E ARROW HWY
Second Line :
City : UPLAND
State : CA
Zip : 91786-4982
Country : US
Telephone Number : 909-932-1069
Fax Number : 909-981-2031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2011
Last Update Date : 01/14/2019

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Directions to “ SHARLENE WHITTEY CADC 1” Practice Location

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