SHEELA SURAPANENI (NPI# 1154445450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154445450 |
| Entity Type | Individual |
| Full Name | SHEELA SURAPANENI |
| Credential | M.D. |
| Practice Address |
23701 E East Fork Rd Azusa CA 91702-1477 |
| Mailing Address |
5021 E Crescent Dr Anaheim CA 92807-3631 |
| Practice Telephone | 6269101202 |
| Practice Fax Number | 6269101380 |
| Mailing Telephone | 7143067409 |
| Mailing Fax Number | 7142793956 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
A50523 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PSYCHIATRY | 2084P0802X | 01 |
| Street Address |
23701 E EAST FORK RD |
| City | AZUSA |
| State | CA |
| Zip Code | 91702-1477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821126939 | Social Model Recovery Systems, Inc. | Community/Behavioral Health | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2007-03-01 |
| 1912518135 | Riley Redman | Case Manager/Care Coordinator | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2020-08-11 |
| 1548893571 | William Robert Hoffman Jr. | Marriage & Family Therapist | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2020-02-18 |
| 1336787092 | Oriana Gregory | Licensed Psychiatric Technician | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2019-12-12 |
| 1972149417 | Isabel Rosales | Case Manager/Care Coordinator | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2019-11-19 |
| 1538704531 | Devon Edward Lucas | Case Manager/Care Coordinator | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2019-11-13 |
| 1518509132 | Steven Stanislas Roseren | Case Manager/Care Coordinator | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2019-10-15 |
| 1336780816 | Stephanie Marie Hernandez | Case Manager/Care Coordinator | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2019-10-04 |
| 1194382317 | Kristin Wopschall | Case Manager/Care Coordinator | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2019-05-22 |
| 1902460868 | Leandro Perez IIi | Case Manager/Care Coordinator | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2019-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407345341 | Rosaura Contreras | Nutritionist | 109 West 6th Street, Azusa, CA 91702 | 2018-05-07 |
| 1093224396 | Beatriz Leyva Torres | Nurse Practitioner | 237 S. Vernon Ave, Azusa, CA 91702 | 2017-09-29 |
| 1871949370 | Angela Marie Mckindley | Case Manager/Care Coordinator | 23701 East Fork Rd., Azusa, CA 91702 | 2016-05-13 |
| 1023489846 | Crystal Horton | Case Manager/Care Coordinator | 23701 E Fork Road, Azusa, CA 91702 | 2015-10-20 |
| 1528438272 | Seann Mckay | Case Manager/Care Coordinator | 23701 E Folk Rd, Azusa, CA 91702 | 2015-10-06 |
| 1437528833 | William Clabaugh | Case Manager/Care Coordinator | 830 S. Azusa Ave., 45, Azusa, CA 91702 | 2015-09-16 |
| 1467850693 | Juana Gaeta | Speech-Language Pathologist | 1016 E Ghent St, Azusa, CA 91702 | 2014-12-22 |
| 1649674508 | Colleen Anne Montz | Nurse Practitioner | 901 E. Alosta Ave., Student Health Center, Azusa, CA 91702 | 2014-10-21 |
| 1285061390 | Patrick Ryan Bergeron | Physical Therapist | 900 W Sierra Madre Avenue, #33, Azusa, CA 91702 | 2013-10-03 |
| 1760768972 | Ashley L Wickliffe | Student in an Organized Health Care Education/Training Program | 901 East Alosta Avenue, Azusa, CA 91702 | 2011-11-01 |
| Find all providers in zip 91702 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184111494 | Lags Spine and Sportscare Medical Centers, Inc. | Psychiatry & Neurology | 1223 Higuera St Ste 101, San Luis Obispo, CA 93401-3167 | 2018-04-23 |
| 1053808899 | Klc Consultants, PC | Psychiatry & Neurology | 1808 Verdugo Blvd Ste 319, Glendale, CA 91208-1486 | 2018-04-17 |
| 1780196733 | Acceptance Detox LLC | Psychiatry & Neurology | 18779 Palm St, Fountain Valley, CA 92708-6428 | 2017-10-31 |
| 1952824021 | Novation Behavioral Health, LLC | Psychiatry & Neurology | 1707 E Bay Ave, Newport Beach, CA 92661-1453 | 2017-07-20 |
| 1912362567 | Sanjoy Sathpathy, M.d. Inc | Psychiatry & Neurology | 9888 Carroll Center Road, 218, San Diego, CA 92126-4515 | 2015-12-28 |
| 1043562630 | San Diego Professional Group, P. C. | Psychiatry & Neurology | 41655 Date St, Suite 101a, Murrieta, CA 92562-7040 | 2012-10-08 |
| 1841591690 | David E. Brody | Psychiatry & Neurology | 13200 South Bloomfield Ave, Norwalk, CA 90650 | 2010-11-10 |
| 1124342647 | Vicki Kalira | Psychiatry & Neurology | 150 Muir Rd Bldg 24, Martinez, CA 94553-4668 | 2010-03-26 |
| 1710127964 | Pacific Composure Psychiatry & Hypnotherapy | Psychiatry & Neurology | 180 7th Ave Ste 103, Santa Cruz, CA 95062-4732 | 2009-02-28 |
| 1235341330 | Timmen Cermak | Psychiatry & Neurology | 239 Miller Avenue, Suite #1, Mill Valley, CA 94941 | 2007-05-03 |
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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.