Active NPI
Shannon Eileen Hanrahan, PSY AND MFT
- Psychologist
- Fullerton, CA
National Provider Identifier
1841405586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 23375
- Practice address
- 227 W Santa Fe Ave
Fullerton, CA 92832-1829 - Phone
- (714) 928-9580
- Fax
- (714) 447-9807
- NPI assigned
- May 14, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 34839 | CA | |
| Psychologist | 103T00000X | PSY 23375 | CA | Primary |
Addresses
Primary practice location
227 W Santa Fe Ave
Fullerton, CA 92832-1829
Mailing address
227 W Santa Fe Ave
Fullerton, CA 92832-1829
Phone (714) 928-9580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 351247YKWY | Other | NM | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 4, 2024 through Jan 4, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 23375 | CA | MD | Psychologist |
| MFC 34839 | CA | MD | Marriage & Family Therapist |
| 23375 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1841405586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 W SANTA FE AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321829",
"telephone_number": "714-928-9580",
"fax_number": "714-447-9807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 W SANTA FE AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321829",
"telephone_number": "714-928-9580",
"fax_number": "714-447-9807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANRAHAN",
"first_name": "SHANNON",
"middle_name": "EILEEN",
"name_prefix": "Dr.",
"credential": "PSY AND MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 34839",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 23375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "351247YKWY",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.