Individual provider Active NPI

Shannon Williams

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1043625650
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
102638 Issued in CA
Practice address
2121 W Temple St
Los Angeles, CA 90026-4915
Phone
(213) 385-5100
NPI assigned
Jun 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 102638 CA Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

2121 W Temple St
Los Angeles, CA 90026-4915

Mailing address

2121 W Temple St
Los Angeles, CA 90026-4915
Phone (213) 385-5100

Other practice location 1

2275 Arlington Dr
San Leandro, CA 94578-1132
Phone (510) 317-1444

Other practice location 2

2892 N Bellflower Blvd
Ste 424
Long Beach, CA 90815-1125
Phone (510) 317-1444

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
102638CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rising Anchor Individual Marriage and Family Therapy Inc Marriage & Family Therapist Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1043625650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 W TEMPLE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264915",
            "telephone_number": "213-385-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W TEMPLE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264915",
            "telephone_number": "213-385-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2275 Arlington Dr",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945781132",
            "country_code": "US",
            "telephone_number": "510-317-1444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2892 N Bellflower Blvd",
            "address_2": "Ste 424",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908151125",
            "country_code": "US",
            "telephone_number": "510-317-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102638",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.