Active NPI
Shawn Roth
- Marriage & Family Therapist
- Newport Beach, CA
National Provider Identifier
1942812995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 154414
- Practice address
- 3700 Campus Dr Ste 206
Newport Beach, CA 92660-2604 - Phone
- (949) 702-5684
- NPI assigned
- Aug 20, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 154414 | CA | Primary |
Addresses
Primary practice location
3700 Campus Dr Ste 206
Newport Beach, CA 92660-2604
Mailing address
1405 Piedmont
Irvine, CA 92620-3804
Phone (702) 480-9135
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
| License | State | Type | Specialty |
|---|---|---|---|
| 154414 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744156800000",
"number": "1942812995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 PIEDMONT",
"city": "IRVINE",
"state": "CA",
"postal_code": "926203804",
"telephone_number": "702-480-9135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 CAMPUS DR STE 206",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602604",
"telephone_number": "949-702-5684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "SHAWN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-20",
"last_updated": "2025-04-09",
"certification_date": "2025-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "154414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.