Individual provider Active NPI

Stefan James Shakiba

  • Marriage & Family Therapist
  • West Covina, CA
National Provider Identifier
1346521242
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT87666 Issued in CA
Practice address
100 N Barranca St Ste 130
West Covina, CA 91791-1637
Phone
(626) 433-1311
NPI assigned
Sep 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 87666 CA
Marriage & Family Therapist 106H00000X LMFT87666 CA Primary

Addresses

Primary practice location

100 N Barranca St Ste 130
West Covina, CA 91791-1637

Mailing address

100 N Barranca St Ste 130
West Covina, CA 91791-1637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815003294 CA Practitioner - Marriage and Family Therapist 4789183898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

1020 S Arroyo Pkwy
Pasadena, CA 91105-3911
Phone (626) 403-2794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
87666CAMDMarriage & Family Therapist
LMFT87666CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics CurrentSince May 22, 2025 Accepting new patients
Pacific Clinics CurrentSince Feb 9, 2025 Accepting new patients
Pacific Clinics Current Accepting new patients
Pacific Clinics CurrentSince May 22, 2025 Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

9864 Baldwin Pl
El Monte, CA 91731
Phone (626) 433-1316

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

100 N Barranca St
Ste 130
West Covina, CA 91791
Phone (626) 433-1313

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1346521242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BARRANCA ST STE 130",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BARRANCA ST STE 130",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911637",
            "telephone_number": "626-433-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKIBA",
        "first_name": "STEFAN",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "87666",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT87666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.