Individual provider Active NPI

Praachi Shan

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1205684909
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
141491 Issued in CA
Practice address
505 N Tustin Ave Ste 265
Santa Ana, CA 92705-3775
Phone
(866) 766-4935
NPI assigned
May 8, 2024
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 14543 CA
Marriage & Family Therapist 106H00000X 141491 CA Primary

Addresses

Primary practice location

505 N Tustin Ave Ste 265
Santa Ana, CA 92705-3775

Mailing address

171 Paintbrush LN
Paintbrush Lane
Burnet, TX 78611
Phone (714) 809-1200

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
141491CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Wellness & Family Counseling, Inc. CurrentSince May 12, 2024 Accepting new patients
Peace of Mind Center for Wellness CurrentSince May 12, 2024 Accepting new patients

Locations

505 N Tustin Ave
Ste 265
Santa Ana, CA 92705
Phone (714) 809-1200

Organizations & group practices 2

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": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1205684909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 PAINTBRUSH LN",
            "address_2": "PAINTBRUSH LANE",
            "city": "BURNET",
            "state": "TX",
            "postal_code": "78611",
            "telephone_number": "714-809-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N TUSTIN AVE STE 265",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053775",
            "telephone_number": "866-766-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAN",
        "first_name": "PRAACHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "14543",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.