Individual provider Active NPI

Kelsi Shannon

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1023634623
Registry record updated May 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1428 Phillips LN Ste 202
San Luis Obispo, CA 93401-2567
Phone
(806) 441-2954
NPI assigned
Jun 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1428 Phillips LN Ste 202
San Luis Obispo, CA 93401-2567

Mailing address

PO Box 1713
Solana Beach, CA 92075-7713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779494400000",
    "number": "1023634623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1713",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920757713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 PHILLIPS LN STE 202",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012567",
            "telephone_number": "806-441-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KELSI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2026-05-23",
        "certification_date": "2026-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.