Shannon Ryan, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

44076 Issued in CA

Practice address

540 Middle Rincon Rd
Santa Rosa, CA 95409-3107

Phone

(707) 909-0168

NPI assigned

May 11, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Petaluma People Services Center

  • Community/Behavioral Health Agency
  • Petaluma, CA
  • NPI 1396951430
  NPD (past)
• Petaluma People Services Center

  • Community/Behavioral Health Agency
  • Petaluma, CA
  • NPI 1558405126
  NPD (past)

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1255565867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MIDDLE RINCON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093107",
            "telephone_number": "707-909-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MIDDLE RINCON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093107",
            "telephone_number": "707-909-0168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1456 Professional Dr Ste 406",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949546639",
            "country_code": "US",
            "telephone_number": "707-273-1007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Petaluma Blvd S",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949525545",
            "country_code": "US",
            "telephone_number": "707-765-8488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SHANNON",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "44076",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV BOARD OF MARRIAGE AND FAMILY THERAPIST",
            "identifier": "01154",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "44076",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brigid S. Ryan, MFT
• Eric Lee Ryan, PH.D.
• Kevin Jenoy Ryan
• Romney Ryan, PH.D.
• Samantha Ryan
• Stevie Rybacki
• Maria Theresa Saavedra, SLP
• Jasdeep Singh Sabharwal, MD
• Gregory Neill Sacher, MD
• Aynna Y. Sae, MD

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, 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 Sep 28, 2023; 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.