Individual provider Active NPI

Jody Evelyn Shephard, LMFT

  • Marriage & Family Therapist
  • Bonita, CA
National Provider Identifier
1023742954
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT30955 Issued in CA
Practice address
3761 Bonita Glen Terrace
Bonita, CA 91902
Phone
(619) 995-4021
NPI assigned
Jul 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 LMFT30955 CA Primary

Addresses

Primary practice location

3761 Bonita Glen Terrace
Bonita, CA 91902

Mailing address

3761 Bonita Glen Terrace
Bonita, CA 91902
Phone (619) 995-4021

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

State licenses

LicenseStateTypeSpecialty
LMFT30955CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: jody.shephard.p1@direct.sokya.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1023742954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3761 BONITA GLEN TERRACE",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "91902",
            "telephone_number": "619-995-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3761 BONITA GLEN TERRACE",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "91902",
            "telephone_number": "619-995-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHARD",
        "first_name": "JODY",
        "middle_name": "EVELYN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT30955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.