Kimberly Scott Shaw, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

46135 Issued in CA

Practice address

140 Mayhew Way Ste 300
Pleasant Hill, CA 94523-4398

Phone

(510) 495-4217

NPI assigned

Jun 18, 2019

Last updated

Jun 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Kimberly Shaw, MFT

  • Marriage & Family Therapist
  • Pleasant Hill, CA
  • NPI 1063142354
  NPD Authorized official

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1083274328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 SYCAMORE AVE UNIT 5632",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945476027",
            "telephone_number": "510-495-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MAYHEW WAY STE 300",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234398",
            "telephone_number": "510-495-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KIMBERLY",
        "middle_name": "SCOTT",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cree Seymens-Brackett
• Armatis A Shabani, PA-C
• Yasmin Shamloo
• Anupama Shani
• Kyra Sharpe
• Briana Shewan
• Don K Shimizu, D.D.S.
• Grant Shimizu
• Laarni Shimizu, DDS
• Richard Craig Shinaman, MD

• Marriage & Family Therapist in Pleasant Hill, CA
• Providers in Pleasant Hill, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.