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EDEN SHANAY ICE
NPI 1205420684
Counselor - Addiction (Substance Use Disorder) in San Diego, CA

Active since February 25, 2021
1733 EUCLID AVE, SAN DIEGO, CA 92105(619) 263-0433(619) 263-3992 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2025, Feb 25, 2021 (2 updates tracked since 2021).

About Eden Shanay Ice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDEN SHANAY ICE (NPI 1205420684) is an individual addiction (substance use disorder) provider in San Diego, California and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1205420684
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameEDEN SHANAY ICE
Location Address1733 EUCLID AVESan Diego, CA 92105-5414
Mailing Address1390 Santa Alicia AveChula Vista, CA 91913-1850 · (619) 455-2449
Phone(619) 263-0433
Fax(619) 263-3992
Sole ProprietorNo
Enumeration DateFebruary 25, 2021
Last NPPES UpdateJune 16, 20252 updates tracked since enumeration
NPPES CertifiedJune 16, 2025
✔ NPI 1205420684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Also ListedBehavior TechnicianTaxonomy 106S00000X
1733 EUCLID AVE, San Diego, CA 92105
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIFFANY ANN MILLER CMA, CMAA
Nurse's Aide
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433
ELIZABETH MARIA TERRY I
Counselor (Addiction (Substance Use Disorder))
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433
ANGEL SANTANA CABANILLAS DELEON SUDRC
Counselor (Addiction (Substance Use Disorder))
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433
EILEEN VASQUEZ
Counselor (Addiction (Substance Use Disorder))
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433
MR. ERIC RYAN GROFF RRW
Counselor (Addiction (Substance Use Disorder))
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433
MS. JENNIFER JOELLA VEJAR
Counselor (Addiction (Substance Use Disorder))
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433
MS. HEATHER NEWHART
Counselor (Addiction (Substance Use Disorder))
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433
MR. CHARLES NEILL MUSSER RADTI
Counselor (Addiction (Substance Use Disorder))
1733 EUCLID AVE
SAN DIEGO, CA 92105
San Diego County (619) 263-0433

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eden Ice's NPI number?

The NPI number for Eden Ice is 1205420684. It was assigned to this individual provider in the NPPES registry on February 25, 2021.

Where is Eden Ice located?

Eden Ice practices at 1733 Euclid Ave, San Diego, CA 92105. The listed phone number is (619) 263-0433.

What is Eden Ice's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Eden Ice was last updated on June 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.