Active NPI
Sharon Renee Odom, M.S. MFT
- Mental Health Counselor
- Modesto, CA
National Provider Identifier
1740469626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 42146
- Practice address
- 2125 Wylie Dr Ste 9
Modesto, CA 95355-3847 - Phone
- (209) 450-4265
- Fax
- (209) 579-5710
- NPI assigned
- Oct 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 42146 | CA | Primary |
Addresses
Primary practice location
2125 Wylie Dr Ste 9
Modesto, CA 95355-3847
Mailing address
PO Box 578601
Modesto, CA 95357-8601
Phone (209) 450-6245
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240702003405 | CA | Practitioner - Marriage and Family Therapist | 5294279170 | Practice locations: Modesto, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1601 I St
Suite 320
Modesto, CA 95354-1135
Phone (209) 450-6245
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42146 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193616000000",
"number": "1740469626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 578601",
"city": "MODESTO",
"state": "CA",
"postal_code": "953578601",
"telephone_number": "209-450-6245",
"fax_number": "209-579-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 WYLIE DR STE 9",
"city": "MODESTO",
"state": "CA",
"postal_code": "953553847",
"telephone_number": "209-450-4265",
"fax_number": "209-579-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODOM",
"first_name": "SHARON",
"middle_name": "RENEE",
"credential": "M.S. MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-29",
"last_updated": "2007-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "42146",
"primary": true
}
],
"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 29, 2007; 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.