SHANE FULLER
NPI 1497112114
Counselor - Addiction (Substance Use Disorder) in Wilton, CA

Q: What is Shane Fuller's NPI number?

The NPI number for Shane Fuller is 1497112114. It was assigned to this individual provider in the NPPES registry on January 26, 2016.

Q: What is Shane Fuller's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Shane Fuller was last updated on January 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.

Active since January 26, 2016

11255 MANN RD, WILTON, CA 95693(916) 606-0027 Get Directions Write a Review

NPPES record last updated: January 26, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Shane Fuller NPPES

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

SHANE FULLER (NPI 1497112114) is an individual addiction (substance use disorder) provider in Wilton, California and active in the NPI registry since January 2016.

NPPES Registry Identity

NPI1497112114

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameSHANE FULLER

Location Address11255 MANN RDWilton, CA 95693-9712

Mailing Address11255 Mann RdWilton, CA 95693-9712 · (916) 606-0027

Phone(916) 606-0027

Sole ProprietorNo

Enumeration DateJanuary 26, 2016

✔ NPI 1497112114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

11255 MANN RD, Wilton, CA 95693

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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 Shane Fuller's NPI number?

The NPI number for Shane Fuller is 1497112114. It was assigned to this individual provider in the NPPES registry on January 26, 2016.

Where is Shane Fuller located?

Shane Fuller practices at 11255 Mann Rd, Wilton, CA 95693. The listed phone number is (916) 606-0027.

What is Shane Fuller'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 Shane Fuller was last updated on January 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.