Kanika Lynn Shelly, LMFT123786

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

123786 Issued in CA

Practice address

1503 Macdonald Ave Ste a-710
Richmond, CA 94801-3267

Phone

(707) 656-2146

NPI assigned

May 14, 2014

Last updated

Jul 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jamaa Healing Collective Wellness Services

  • Marriage & Family Therapist
  • Richmond, CA
  • NPI 1952256224
  NPD Authorized official

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1447661277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 MACDONALD AVE STE A-710",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948013267",
            "telephone_number": "707-656-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 MACDONALD AVE STE A-710",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948013267",
            "telephone_number": "707-656-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "KANIKA",
        "middle_name": "LYNN",
        "credential": "LMFT123786",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William H. Shalen, MD
• Gary Evan Shaller, PH.D.
• Ruby Shapiro, OTD, OTR/L
• David Shaw, MFT
• Ronald D Shaw
• Kay Tak Shen, D.M.D.
• Levy Jiao-Jue Sheng
• Surendra T. Shenoy, MD
• John D. Sheppard, MD
• Kanaka D Shetty, M.D.

• Marriage & Family Therapist in Richmond, CA
• Providers in Richmond, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.