Individual provider Active NPI

Shoshona Pascoe, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1275674368
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC35642 Issued in CA
Practice address
405 Chinn St
#104
Santa Rosa, CA 95404-4309
Phone
(707) 573-9575
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC35642 CA Primary

Addresses

Primary practice location

405 Chinn St
#104
Santa Rosa, CA 95404-4309

Mailing address

405 Chinn St
#104
Santa Rosa, CA 95404-4309
Phone (707) 573-9575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 26, 2024 through Jan 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC35642CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275674368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CHINN ST",
            "address_2": "#104",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044309",
            "telephone_number": "707-573-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CHINN ST",
            "address_2": "#104",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044309",
            "telephone_number": "707-573-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCOE",
        "first_name": "SHOSHONA",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC35642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.