Active NPI
Kathleen Noelle Shannon, M.A., .M.F.C.
- Marriage & Family Therapist
- Huntington Beach, CA
National Provider Identifier
1780749416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 49712
- Practice address
- 18811 Huntington St
Suite 200
Huntington Beach, CA 92648 - Phone
- (928) 925-2467
- Fax
- (714) 969-8808
- NPI assigned
- Dec 22, 2006
- Last updated
- Apr 1, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C.A.D.A.C. 1591 | AZ | |
| Mental Health Counselor | 101YM0800X | L.P.C. 2093 | AZ | |
| Marriage & Family Therapist | 106H00000X | 49712 | CA | Primary |
Addresses
Primary practice location
18811 Huntington St
Suite 200
Huntington Beach, CA 92648
Mailing address
PO Box 7086
Huntington Beach, CA 92615-7086
Phone (928) 925-2467
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.A.D.A.C. 1591 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
| L.P.C. 2093 | AZ | MD | Mental Health Counselor |
| 49712 | CA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1780749416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7086",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926157086",
"telephone_number": "928-925-2467",
"fax_number": "714-969-8808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18811 HUNTINGTON ST",
"address_2": "SUITE 200",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "92648",
"telephone_number": "928-925-2467",
"fax_number": "714-969-8808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "KATHLEEN",
"middle_name": "NOELLE",
"name_prefix": "Ms.",
"credential": "M.A., .M.F.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "C.A.D.A.C. 1591",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "L.P.C. 2093",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "49712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
- Shalini Shah DDS Inc. (A Kids Dentist)
- Shamrock Medical, LLC
- Shang DMD Dental Corporation
- Wynn Shang, DMD
- Amber Shannon, RN, BSN, CMC, HPCN
- Michael J. Shannon, BC-HIS
- Yen Yenta Shao, DMD
- Barbara Elizabeth Shapiro, RN
- Jonathan Lawrence Shapiro, DMD
- Sharifian and Huston Dental Corporation (Beach Dental Group)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.