Individual provider Active NPI

Michelle Shegda

  • Marriage & Family Therapist
  • Venice, CA
National Provider Identifier
1114613858
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
146832 Issued in CA
Practice address
503 Ocean Front Walk
Venice, CA 90291-2403
Phone
(310) 392-3070
NPI assigned
Apr 14, 2023
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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 146832 CA Primary

Addresses

Primary practice location

503 Ocean Front Walk
Venice, CA 90291-2403

Mailing address

503 Ocean Front Walk
Venice, CA 90291-2403
Phone (267) 303-0965

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
146832CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Houses of Los Angeles, Inc. PastSince Apr 16, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1114613858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "267-303-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "310-392-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEGDA",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "146832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.