Kelly Nicole Shah, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

107969 Issued in CA

Practice address

1811 Santa Rita Rd Ste 224
Pleasanton, CA 94566-4732

Phone

(530) 994-6428

NPI assigned

Jul 7, 2014

Last updated

Mar 24, 2025By 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

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Healthright 360

  • Community/Behavioral Health Agency
  • South San Francisco, CA
  • NPI 1265563688
  NPD (past)

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1528474970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 SANTA RITA RD STE 224",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945664732",
            "telephone_number": "530-994-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 SANTA RITA RD STE 224",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945664732",
            "telephone_number": "530-994-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "107969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Seubert, BCBA
• Seva Homecare, LLC
• Christopher Clark Severson, MD
• Ka'Myah Shackelford
• Aashi Ritesh Shah
• Molly Rankin Shah, PA
• Rimpal Shah, PT
• Rina P. Shah, MD
• Sherene Norene Shahin, PA-C
• Summia Shaikh

• Mental Health Counselor in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.