Behrooz Shafiezadeh, LMFT, APCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

139343 Issued in CA

Practice address

2101 Courage Dr
Fairfield, CA 94533-6717

Phone

(707) 784-2077

NPI assigned

Dec 13, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of SolanoGroup PAC ID 7911893177, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• County of Solano

  • Public Health or Welfare Agency
  • Fairfield, CA
  • NPI 1508072588
  Medicare reassignment Care Compare group NPD
• County of Solano

  • Federally Qualified Health Center (FQHC)
  • Fairfield, CA
  • NPI 1083845275
  NPD
• County of Solano

  • Adult Companion
  • Vacaville, CA
  • NPI 1740402452
  NPD

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1639613409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945330051",
            "telephone_number": "510-219-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIEZADEH",
        "first_name": "BEHROOZ",
        "credential": "LMFT, APCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-13",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "139343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENCE",
            "identifier": "C5252989",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jowhar Shabazz
• Mojdeh Shafaghi
• Christopher Shafer
• Kathleen M. Shafer, M.A., R.D.
• Adam Shaffer, D.D.S.
• Ami Shah
• Paarth Mehul Shah, MD
• Parimal K Shah, MD
• Shilpa Shah
• Imara Jana Shaheed

• Marriage & Family Therapist in Fairfield, CA
• Providers in Fairfield, 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 Jun 1, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.