Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Phillip Shack Utumapu, RAS

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1962834721

Mr. Phillip Shack Utumapu, RAS is an Addiction (Substance Use Disorder) Counselor in Yucaipa, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2013
Specialties on file
2

Practice location Address checks out

13626 Holmes St Apt 16
Yucaipa, CA 92399-5567
Phone: (760) 619-0663
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X (CA)
Mental Health Counselor Taxonomy 101YM0800X (CA)

Record details

NPI number1962834721
Entity typeIndividual (Type 1)
GenderMale
Credentials RAS
Sole proprietorYes
NPI enumeratedAugust 5, 2013
Last updated in NPPESAugust 5, 2013
Mailing address13626 Holmes St Apt 16, Yucaipa, CA 92399-5567

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