Individual provider Active NPI

Shannon Santhon, MFT

  • Marriage & Family Therapist
  • Fountain Valley, CA
National Provider Identifier
1407134190
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC36067 Issued in CA
Practice address
17280 Newhope St
Suite 4
Fountain Valley, CA 92708-4270
Phone
(714) 434-3980
Fax
(714) 434-3981
NPI assigned
Jul 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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 MFC36067 CA Primary

Addresses

Primary practice location

17280 Newhope St
Suite 4
Fountain Valley, CA 92708-4270

Mailing address

17280 Newhope St
Suite 4
Fountain Valley, CA 92708-4270
Phone (714) 434-3980

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
MFC36067CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Changing Directions Psychological Corporation PastSince Oct 4, 2020 Accepting new patients

Organizations & group practices 1

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": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1407134190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17280 NEWHOPE ST",
            "address_2": "SUITE 4",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084270",
            "telephone_number": "714-434-3980",
            "fax_number": "714-434-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17280 NEWHOPE ST",
            "address_2": "SUITE 4",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084270",
            "telephone_number": "714-434-3980",
            "fax_number": "714-434-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTHON",
        "first_name": "SHANNON",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC36067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.