Individual provider Active NPI

Shiba Rahimi

  • Clinical Psychologist
  • Sacramento, CA
National Provider Identifier
1477801314
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
31179 Issued in CA
Practice address
1555 River Park Dr Ste 103
Sacramento, CA 95815-4603
Phone
(916) 692-8837
Fax
(916) 200-3196
NPI assigned
Aug 27, 2012
Last updated
Dec 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Rehabilitation Counselor 225C00000X 2012813 CA
Clinical Psychologist 103TC0700X 31179 CA Primary

Addresses

Primary practice location

1555 River Park Dr Ste 103
Sacramento, CA 95815-4603

Mailing address

1555 River Park Dr Ste 103
Sacramento, CA 95815-4603
Phone (916) 692-8837

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
I20191127000629 CA Practitioner - Clinical Psychologist 6204269525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1555 River Park Dr
Suite 103
Sacramento, CA 95815-4603
Phone (916) 692-8837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2012813CAMDRehabilitation Counselor
31179CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Assessment and Development Center of Sacramento Clinical CurrentSince Feb 10, 2020 Accepting new patients

Locations

1555 River Park Dr
Ste 103
Sacramento, CA 95815
Phone (916) 692-8837

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1477801314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 RIVER PARK DR STE 103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154603",
            "telephone_number": "916-692-8837",
            "fax_number": "916-200-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 RIVER PARK DR STE 103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154603",
            "telephone_number": "916-692-8837",
            "fax_number": "916-200-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHIMI",
        "first_name": "SHIBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "CA",
            "license": "2012813",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.