MR. ISRAEL EMMANUEL EL'SHADDAI (NPI# 1063064434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063064434 |
| Entity Type | Individual |
| Full Name | MR. ISRAEL EMMANUEL EL'SHADDAI |
| Practice Address |
11600 Eldridge Ave Sylmar CA 91342-6506 |
| Mailing Address |
15232 Foothill Blvd Unit 132 Sylmar CA 91342-8366 |
| Practice Telephone | 8186863000 |
| Mailing Telephone | 4242797027 |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
E1026634 | CA | Behavioral Health & Social Service Providers |
| Street Address |
11600 ELDRIDGE AVE |
| City | SYLMAR |
| State | CA |
| Zip Code | 91342-6506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203956 | Pedro Eduardo Rivas | Rehabilitation Practitioner | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2020-10-21 |
| 1164058657 | Robert Romulus Jackson I | Case Manager/Care Coordinator | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2020-03-17 |
| 1063068203 | Elizabeth Fredgant | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2019-08-13 |
| 1922567460 | Andreas Eugene Branch | Counselor | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2019-03-14 |
| 1649747585 | Mary Salveron | Licensed Vocational Nurse | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2018-10-29 |
| 1184104671 | Lilly Marie Temple | Student in an Organized Health Care Education/Training Program | 11600 Eldridge Ave, Sylmar, CA 91342 | 2018-08-15 |
| 1538608732 | Ana Gonzalez | Licensed Vocational Nurse | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2017-02-21 |
| 1205260635 | Ryan James Sullivan | Marriage & Family Therapist | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2013-08-21 |
| 1215260518 | Ninoska Molina Weckl | Marriage & Family Therapist | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2009-09-17 |
| 1467686998 | Maxine Marie Hughes | Marriage & Family Therapist | 11600 Eldridge Ave, Sylmar, CA 91342-6506 | 2009-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629687223 | Evelyn Pinto Morales | Technician, Other | 14445 Olive View Dr, Sylmar, CA 91342 | 2020-07-29 |
| 1528520988 | Yeun Lim | Student in an Organized Health Care Education/Training Program | 14445 Olive View Dr., Cottage H1, Attn D. Ray, Sylmar, CA 91342 | 2019-04-04 |
| 1467914317 | Sevak Hovagimyan | Pharmacist | 13677 Foothill Blvd #b, Sylmar, CA 91342 | 2019-04-01 |
| 1619455086 | Cameda Trichele Dickerson | Counselor | Phoenix House 116600 Eldridge, Lake View Terrace, CA 91342 | 2018-07-30 |
| 1407349624 | Joseph Sungkon Choi | Acupuncturist | 10274 Foothill Blvd, Sylmar, CA 91342 | 2018-06-12 |
| 1780194522 | Joe Anthony Cardenas | Specialist/Technologist | 15450 Roxford Street, Sylmar, CA 91342 | 2017-10-06 |
| 1336668466 | Juan Hernandez | Chiropractor | 13950 Foothill Blvd Apt 108, Sylmar, CA 91342 | 2017-09-09 |
| 1891213492 | Richard Ignacio Martinez | Nurse Practitioner | 14987 Oro Grande St., Sylmar, CA 91342 | 2017-09-03 |
| 1104349497 | Vanessa Gamboa | Social Worker | 13145 Bromont Ave., 14, Sylmar, CA 91342 | 2017-07-19 |
| 1982138368 | Christina Guest | Psychiatry & Neurology | Olive View Medical Center, 14445 Olive View Drive, Sylmar, CA 91342 | 2017-04-12 |
| Find all providers in zip 91342 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730609132 | Santiago Jesus Reynoso | Counselor | 13496 Gladstone Ave, Sylmar, CA 91342-2277 | 2017-06-27 |
| 1396103644 | Terry Ramirez | Counselor | 13080 Dronfiled Ave, #62, Sylmar, CA 91342 | 2016-02-02 |
| 1538585054 | Jose Ibarra | Counselor | 14256 Dyer St, Sylmar, CA 91342-4133 | 2014-03-07 |
| 1891034351 | Norman Anthony Snowden | Counselor | 12640 Cathy St, Sylmar, CA 91342-3332 | 2013-02-04 |
| 1043539612 | Jeanette Ida Nicolas | Counselor | 13741 Foothill Blvd Ste 270, Sylmar, CA 91342-3150 | 2010-05-21 |
| 1508004359 | Alex Trevino | Counselor | 12908 Macneil St, Sylmar, CA 91342-4918 | 2009-02-02 |
| 1700051984 | Jennifer Casas | Counselor | 13741 Foothill Blvd Ste 230, Sylmar, CA 91342-3194 | 2008-04-28 |
| 1053519009 | Monica Harvin | Counselor | 13741 Foothill Blvd Ste 240, Sylmar, CA 91342-3152 | 2007-07-10 |
| 1770601122 | Dennis C. Aquino | Counselor | 13741 Foothill Blvd, Suite 240, Sylmar, CA 91342-3133 | 2007-03-26 |
| 1588009302 | Marcela Ruvalcaba | Counselor | 13788 Foothill Blvd, Unit 8, Sylmar, CA 91342-3375 | 2013-05-07 |
| Find all providers in SYLMAR | ||||
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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.