SHANNON KELAITA
NPI 1720382864
Social Worker in San Andreas, CA

Q: What is Shannon Kelaita's NPI number?

The NPI number for Shannon Kelaita is 1720382864. It was assigned to this individual provider in the NPPES registry on January 4, 2011.

Q: What is Shannon Kelaita's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Kelaita was last updated on January 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 04, 2011PECOS EnrolledAccepts Medicare Assignment

891 MOUNTAIN RANCH RD, SAN ANDREAS, CA 95249(209) 754-6525(209) 754-6799 Get Directions Write a Review

NPPES record last updated: January 4, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Shannon Kelaita NPPES

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

SHANNON KELAITA (NPI 1720382864) is an individual social worker in San Andreas, California and active in the NPI registry since January 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1720382864

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameSHANNON KELAITA

Location Address891 MOUNTAIN RANCH RDSan Andreas, CA 95249-9713

Mailing AddressPo Box 128Mokelumne Hill, CA 95245-0128

Phone(209) 754-6525

Fax(209) 754-6799

Sole ProprietorYes

Medical School CMSOtherGraduated 2012

Enumeration DateJanuary 4, 2011

✔ NPI 1720382864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

891 MOUNTAIN RANCH RD, San Andreas, CA 95249

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shannon Kelaita is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628477031

PECOS Enrollment IDI20210603003185

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.

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.

ANNE MARIE TAYLOR

Counselor (Mental Health)