Marissa Catherine Shannon, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT53746 Issued in CA

Practice address

1460 Maria LN Ste 300
Walnut Creek, CA 94596-5314

Phone

(925) 644-0400

NPI assigned

Nov 5, 2009

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 14, 2025 through Feb 14, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1124355631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 MARGUERITE AVE",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945232717",
            "telephone_number": "510-856-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MARIA LN STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965314",
            "telephone_number": "925-644-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MARISSA",
        "middle_name": "CATHERINE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-05",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 60402",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT53746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Shale, MD
• Sabian Shane, B.A.
• Stefanie Shanley, CCC-SLP
• Chandran Shanmugam, MD
• Amanda Shannon, OTR
• David Shapiro
• David Aaron Shapiro, MD
• Jerald Edward Shapiro, L.C.S.W. #5905
• Mohsen Sharifi
• Gauri Badhwar Sharma, D.O.

• Marriage & Family Therapist in Walnut Creek, CA
• Providers in Walnut Creek, 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 Nov 17, 2021; 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.