Individual provider · Type 1 NPI

Shane Douglas Hagan

Addiction (Substance Use Disorder) Counselor · Vallejo, CA

NPI number 1417619263 Active

Practice location

1149 Warren Ave
Vallejo, CA 94591-7512

Call (707) 552-5295 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1417619263

Shane Douglas Hagan's National Provider Identifier is 1417619263, issued on Oct 8, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Vallejo, CA. The record was last updated on Oct 8, 2021.