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MISS SHANETTE MICHELLE IZADI
NPI 1245880087
Counselor - Mental Health in Lancaster, CA

Active since September 13, 2019PECOS Enrolled
176 HOLSTON DR, LANCASTER, CA 93535(000) 000-0000 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 13, 2025, Sep 25, 2020, Jul 10, 2020 and 1 more (4 updates tracked since 2019).

About Miss Shanette Michelle Izadi NPPES

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

MISS SHANETTE MICHELLE IZADI (NPI 1245880087) is an individual mental health provider in Lancaster, California and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Palmdale.

NPPES Registry Identity

NPI1245880087
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMISS SHANETTE MICHELLE IZADI
Location Address176 HOLSTON DRLancaster, CA 93535-4531
Mailing Address3446 Sonya AveRosamond, CA 93560-6831 · (626) 662-3233
Phone(000) 000-0000
Sole ProprietorNo
Enumeration DateSeptember 13, 2019
Last NPPES UpdateMay 13, 20254 updates tracked since enumeration
NPPES CertifiedMay 13, 2025
✔ NPI 1245880087 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedSocial WorkerTaxonomy 104100000X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 97150 (CA)
176 HOLSTON DR, Lancaster, CA 93535
Open in Google Maps ↗

Secondary Practice Location 1

Location 138713 Tierra Subida Ave Ste 104Palmdale, CA 93551-4562 · Phone (661) 583-3142

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Shanette Michelle Izadi is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shanette Izadi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PC
280 mi
Mental Health
99 S ALMADEN BLVD STE 600
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 3,139 clinicians in this Medicare group
NPI 1154994846 (408) 402-4385

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 12

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

REBECCA CAMPOS HURD
Counselor (Professional)
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (949) 274-9440
CARL HODGMAN
Case Manager/Care Coordinator
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (661) 223-5411
EDWINNETTE FAISON
Community Health Worker
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (213) 222-3306
LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
Clinic/Center (Mental Health (Including Community Mental Health Center))
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (661) 582-7789
DR. KELLI ANN RULE PSY.D
Psychologist (Clinical)
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (213) 247-0594
CHRISTINA ANN LLOYD M.A.
Marriage & Family Therapist
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (661) 480-3444
JALEESA JAMISON APCC
Counselor (Professional)
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (213) 655-7440
MAYRA ALEJANDRA HARO RN
Registered Nurse (School)
176 HOLSTON DR
LANCASTER, CA 93535
Los Angeles County (661) 729-2321

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 Shanette Izadi's NPI number?

The NPI number for Shanette Izadi is 1245880087. It was assigned to this individual provider in the NPPES registry on September 13, 2019.

Where is Shanette Izadi located?

Shanette Izadi practices at 176 Holston Dr, Lancaster, CA 93535. The listed phone number is (000) 000-0000.

What is Shanette Izadi's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Shanette Izadi enrolled in Medicare?

Yes. Shanette Izadi is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shanette Izadi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shanette Izadi reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shanette Izadi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shanette Izadi was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.