Individual provider Active NPI

Shanna Lillian Goode, MFT

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1356514103
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 43240 Issued in CA
Practice address
1151 Dove St
Suite 105
Newport Beach, CA 92660-2840
Phone
(714) 454-6668
Fax
(714) 972-8860
NPI assigned
Apr 11, 2008
Last updated
Jan 15, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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 MFC 43240 CA Primary

Addresses

Primary practice location

1151 Dove St
Suite 105
Newport Beach, CA 92660-2840

Mailing address

918 Mabury St
Santa Ana, CA 92701-4461
Phone (714) 454-6668

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
MFC 43240CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1356514103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 MABURY ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014461",
            "telephone_number": "714-454-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST",
            "address_2": "SUITE 105",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602840",
            "telephone_number": "714-454-6668",
            "fax_number": "714-972-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE",
        "first_name": "SHANNA",
        "middle_name": "LILLIAN",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 43240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.