Mia Simone Short

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

22964 Issued in CA

Practice address

1001 Potrero Ave
San Francisco, CA 94110-3518

Phone

(415) 206-5270

NPI assigned

May 24, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• University of California, San Francisco

  • Adolescent and Children Mental Health Clinic/Center
  • San Francisco, CA
  • NPI 1740486315
  NPD (past)

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1649845470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 WALL AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948043247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "MIA",
        "middle_name": "SIMONE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "22964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Don Shore, PH D
• Richard Stephen Shore, M.D.
• William Barry Shore, MD
• Elizabeth Short
• Joshua Patrick Short, MFTI
• Robert Thomas Short III, MD
• Ann Murray Abernethy Shortall, R.N., N.P.
• Jessica L Shost, PHARMD
• Amy Showen, MD, MSC
• Christopher Ramsay Showers, MD

• Professional Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.