Individual provider Active NPI

Jesse Kurtin Little Shapiro

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1851540637
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
83604 Issued in CA
Practice address
2127 Ashby Ave
Berkeley, CA 94705-1884
Phone
(916) 213-1613
NPI assigned
Sep 16, 2008
Last updated
Mar 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 83604 CA Primary

Addresses

Primary practice location

2127 Ashby Ave
Berkeley, CA 94705-1884

Mailing address

2321 Russell St Apt 1F
Berkeley, CA 94705-1958
Phone (916) 213-1613

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

State licenses

LicenseStateTypeSpecialty
83604CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1851540637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 RUSSELL ST APT 1F",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051958",
            "telephone_number": "916-213-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 ASHBY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051884",
            "telephone_number": "916-213-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "JESSE",
        "middle_name": "KURTIN LITTLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "83604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.