Shannon Peterson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A115681 Issued in CA

Practice address

201 N Civic Dr Ste 183
Walnut Creek, CA 94596-3864

Phone

(925) 299-9033

Fax

(925) 299-9030

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Southern California Keck School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mark David Levine MD Professional CorporationGroup PAC ID 0143478305, 165 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mark David Levine M.D. Professional Corporation

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1154697944
  Medicare reassignment Care Compare group NPD
• Mark David Levine Psychiatrists Professional Corporation

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1871866285
  NPD
• Mark David Levine, MD Burlingame PC

  • Psychiatry Physician
  • San Mateo, CA
  • NPI 1770709263
  NPD
• Mark David Levine, MD Oakland PC

  • Psychiatry Physician
  • Oakland, CA
  • NPI 1902022379
  NPD (past)
• Mark David Levinem MD Sunnyvale PC

  • Psychiatry Physician
  • Sunnyvale, CA
  • NPI 1538385943
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1710197041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "916-576-7900",
            "fax_number": "916-285-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CIVIC DR STE 183",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945963864",
            "telephone_number": "925-299-9033",
            "fax_number": "925-299-9030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 E Newton St # M802",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182340",
            "country_code": "US",
            "telephone_number": "617-638-8540",
            "fax_number": "617-638-8542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHANNON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "229585",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A115681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate Petersen, PSY.D
• Colleen Peterson
• Leah Taylor Peterson, AU.D.
• Linda Marie Peterson, CNM
• Marion Macphail Peterson, RN MFT
• John Joseph Petrini Jr., D.D.S, M.S.
• Nicole Ramos Petro, PA-C
• Stacey Elizabeth Petrowsky, MA, LMFT
• David Lewis Pfeifer
• Elizabeth Pfeiffer

• Psychiatry Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.