Active NPI
Shauna J Forsythe
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1306393269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT111445
- Practice address
- 111 N Market St Ste 950
San Jose, CA 95113-1112 - Phone
- (347) 933-8284
- NPI assigned
- Sep 7, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF93891 | CA | |
| Marriage & Family Therapist | 106H00000X | LMFT111445 | CA | Primary |
Addresses
Primary practice location
111 N Market St Ste 950
San Jose, CA 95113-1112
Mailing address
111 N Market St Ste 950
San Jose, CA 95113-1112
Phone (347) 933-8284
Other practice location 1
111 N Market St Ste 950
San Jose, CA 95113-1112
Phone (347) 933-8284
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
| License | State | Type | Specialty |
|---|---|---|---|
| IMF93891 | CA | MD | Marriage & Family Therapist |
| LMFT111445 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570060800000",
"number": "1306393269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N MARKET ST STE 950",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951131112",
"telephone_number": "347-933-8284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N MARKET ST STE 950",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951131112",
"telephone_number": "347-933-8284"
}
],
"practiceLocations": [
{
"address_1": "111 N Market St Ste 950",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "951131112",
"country_code": "US",
"telephone_number": "347-933-8284",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORSYTHE",
"first_name": "SHAUNA",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-07",
"last_updated": "2019-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF93891",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT111445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.