Individual provider Active NPI

Shaundeep Singh Grewal, LMFT

  • Marriage & Family Therapist
  • Bakersfield, CA
National Provider Identifier
1104336353
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
114947 Issued in CA
Practice address
7800 Niles St
Bakersfield, CA 93306-4922
Phone
(661) 328-4284
Fax
(661) 616-9977
NPI assigned
Oct 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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 114947 CA Primary

Addresses

Primary practice location

7800 Niles St
Bakersfield, CA 93306-4922

Mailing address

7800 Niles St
Bakersfield, CA 93306-4922
Phone (661) 328-4284

Other practice location 1

3105 Wilson Rd
Bakersfield, CA 93304-5319
Phone (661) 397-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114947CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1104336353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064922",
            "telephone_number": "661-328-4284",
            "fax_number": "661-616-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064922",
            "telephone_number": "661-328-4284",
            "fax_number": "661-616-9977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3105 Wilson Rd",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933045319",
            "country_code": "US",
            "telephone_number": "661-397-8775",
            "fax_number": "661-397-8286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "SHAUNDEEP",
        "middle_name": "SINGH",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-02",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.