Individual provider Active NPI

Sheboan Marie Rivera

  • Marriage & Family Therapist
  • Modesto, CA
National Provider Identifier
1639719255
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT141367 Issued in CA
Practice address
1001 Needham St
Modesto, CA 95354-0730
Phone
(209) 569-0373
NPI assigned
Jan 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X AMFT141367 CA Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

1001 Needham St
Modesto, CA 95354-0730

Mailing address

1001 Needham St
Modesto, CA 95354-0730
Phone (209) 569-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AMFT141367CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Turning Point Community Programs CurrentSince Nov 30, 2025 Accepting new patients
County of Stanislaus PastSince Jan 2, 2022 Accepting new patients
Kadiant, LLC PastSince Jan 1, 2020 Accepting new patients
Centra Medical Group, LLC PastSince Jan 1, 2020 Accepting new patients

Locations

1001 Needham St
Modesto, CA 95354
Phone (209) 544-1913

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1578700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1639719255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NEEDHAM ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953540730",
            "telephone_number": "209-569-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NEEDHAM ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953540730",
            "telephone_number": "209-569-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "SHEBOAN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-11",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT141367",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.