Shenandoah Dawn Reynolds, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC53089 Issued in CA

Practice address

2960 Camino Diablo
210
Walnut Creek, CA 94597-3988

Phone

(925) 938-2282

NPI assigned

Apr 8, 2010

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

Other identifiers 1

Other names 1

• Shenandoah Dawn Reynolds Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1528384104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 NE ALOCLEK DR",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247135",
            "telephone_number": "503-858-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 CAMINO DIABLO",
            "address_2": "210",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973988",
            "telephone_number": "925-938-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SHENANDOAH",
        "middle_name": "DAWN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC53089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT LICENSE",
            "identifier": "53089",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3175 NE Aloclek Dr",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971247135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHENANDOAH",
            "last_name": "REYNOLDS",
            "middle_name": "DAWN",
            "credential": "MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jimmie Reyes
• Jaylyn Reynolds
• Jennifer Nicole Reynolds, OTR/L
• Joan Reynolds, M.D.
• Jodi Reynolds, P.A.
• Carmen Marina Rhodes, BS
• Caitlin Rice
• Myranda Rich
• Philip J. Rich, MD
• Richard D Smith M D Inc.

• Marriage & Family Therapist in Walnut Creek, CA
• Providers in Walnut Creek, 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 Mar 7, 2022; 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.