Individual provider Active NPI

Shannon Yvonne Dornbrach

  • Massage Therapist
  • San Luis Obispo, CA
National Provider Identifier
1790682946
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
93577 Issued in CA
Practice address
2701 McMillan Ave Ste 160
San Luis Obispo, CA 93401-4744
Phone
(530) 210-3514
NPI assigned
Oct 21, 2026
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 93577 CA Primary

Addresses

Primary practice location

2701 McMillan Ave Ste 160
San Luis Obispo, CA 93401-4744

Mailing address

3053 Rockview PL
San Luis Obispo, CA 93401-6711
Phone (530) 210-3514

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

NPI Registry JSON

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

{
    "created_epoch": "1792540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1790682946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 ROCKVIEW PL",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016711",
            "telephone_number": "530-210-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MCMILLAN AVE STE 160",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014744",
            "telephone_number": "530-210-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNBRACH",
        "first_name": "SHANNON",
        "middle_name": "YVONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-21",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "93577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.