Kristina J Shippey

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

104850 Issued in CA

Practice address

1411 Marsh Street
Suite 206
San Luis Obispo, CA 93401

Phone

(805) 781-3535

NPI assigned

Jun 21, 2007

Last updated

Feb 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristina Jean Shippey Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Aug 26, 2024 through Aug 26, 2026

Medicare enrollment (NPD)

Not enrolled

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.

• Flourish and Grow Family Therapy, Inc.

  • Marriage & Family Therapist
  • San Luis Obispo, CA
  • NPI 1477340289
  NPD Authorized official

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1649476326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 MARSH STREET",
            "address_2": "SUITE 206",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MARSH STREET",
            "address_2": "SUITE 206",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-781-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPPEY",
        "first_name": "KRISTINA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "104850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "SHIPPEY",
            "middle_name": "JEAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mark D Sherman, MD
• Cynthia Shibutani
• Madison Shields
• Shelley Lynn Shields
• Kara Anne Prinz Shipcott, MA
• Cheryl Shivaprasad, PPS
• Carolyn NMN Shively
• Alexis Henley Shohet
• Jessie Shorts
• Amanda Shrewsbury

• Marriage & Family Therapist in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.