Shannon Nosenzo-Goodman, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

42520 Issued in CA

Practice address

1132 San Marino Dr Ste 204
San Marcos, CA 92078-4600

Phone

(209) 920-7828

Fax

(760) 471-1803

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannonnosenzogoodman@tdh.allscriptsdirect.net

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.

• Lifespan Therapy Group

  • Marriage & Family Therapist
  • San Marcos, CA
  • NPI 1821948845
  Medicare reassignment NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1104961630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 LA TIERRA LN",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784619",
            "telephone_number": "760-402-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 SAN MARINO DR STE 204",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784600",
            "telephone_number": "209-920-7828",
            "fax_number": "760-471-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSENZO-GOODMAN",
        "first_name": "SHANNON",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LMFT42520",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "42520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North County Health Services
• North County Lifeline
• North County Lifeline
• North County Lifeline
• North County Womens Medical Clinic,Inc
• Nosti and Reagan Dental Corporation
• Thomas Joseph Noto Jr., P.T.
• Angelica Notovich
• Michael Andrew Novikoff, D.D.S.
• Thays Schouwe Novikoff, M.D.

• Marriage & Family Therapist in San Marcos, CA
• Providers in San Marcos, 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 Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.