Marissa B Shennan, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

94199 Issued in CA

Practice address

2142 N Blythe Ave
Fresno, CA 93722-5402

Phone

(559) 276-7680

NPI assigned

Aug 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 6

Other names 1

• Marissa B Homburg Former name

Medicare fee-for-service enrollment

Enrolled in ID, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marissashennan@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cyti Health PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1679172290
  Medicare reassignment NPD
• Fusion Care Group, a Psychological Professional Corporation

  • Clinical Psychologist
  • Alpine, CA
  • NPI 1275177982

  ID

  Medicare reassignment NPD
• MBS Therapy Services LLC

  • Marriage & Family Therapist
  • Rathdrum, ID
  • NPI 1063343721
  NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Core Conditions, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Fresno, CA
  • NPI 1225697535
  NPD (past)

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1952857435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13867 W HIGHWAY 53 UNIT 605",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838584025",
            "telephone_number": "559-997-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N BLYTHE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937225402",
            "telephone_number": "559-276-7680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 S Brawley Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937062103",
            "country_code": "US",
            "telephone_number": "559-443-2166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3765 W Dakota Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937224784",
            "country_code": "US",
            "telephone_number": "559-271-8421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13867 W Highway 53 Unit 605",
            "address_purpose": "LOCATION",
            "city": "Rathdrum",
            "state": "ID",
            "postal_code": "838584025",
            "country_code": "US",
            "telephone_number": "559-997-6270",
            "fax_number": "559-336-6758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 W Bannock St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026140",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "402 W Broadway Ste 400",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921013554",
            "country_code": "US",
            "telephone_number": "866-478-3978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Alaskan Way S Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042785",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 W Broadway Fl 7",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841012060",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 SW 5th Ave Ste 3150",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972043656",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1218 N Division Ave Ste 217",
            "address_purpose": "LOCATION",
            "city": "Sandpoint",
            "state": "ID",
            "postal_code": "838645054",
            "country_code": "US",
            "telephone_number": "888-688-0248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3793 N Polk Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937229763",
            "country_code": "US",
            "telephone_number": "559-271-2166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2271 Alpine Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Alpine",
            "state": "CA",
            "postal_code": "919011101",
            "country_code": "US",
            "telephone_number": "559-997-6270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 SW 8th St Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331303038",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENNAN",
        "first_name": "MARISSA",
        "middle_name": "B",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MFT.LF.70115487",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ME",
            "license": "MF8953",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "TPMF2014",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T2530",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-8351",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94199",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MFPL.MK.70115486",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "14278760-3902",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS",
            "identifier": "T2530",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSES",
            "identifier": "LMFT-8351",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "94199",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF UTAH DEPARTMENT OF PROFESSIONAL LICENSING",
            "identifier": "14278760-3902",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLHT LICENSED MARRIAGE AND FAMILY THERAPIST",
            "identifier": "TPMF2014",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "MFPL.MK.70115486",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "HOMBURG",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Rena Sheng
• Nandita Shenton
• Shepherd Family Home
• Shepherd Home
• Misty Dawn Shepherd
• Krunal Sherathiya, BDS, DDS, MS

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.