Individual provider Active NPI

Jennifer Shelton

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1962941872
Registry record updated Oct 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
119918 Issued in CA
Practice address
420 Folsom Rd Suite C
Roseville, CA 95678-2223
Phone
(916) 461-4832
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 119918 CA Primary

Addresses

Primary practice location

420 Folsom Rd Suite C
Roseville, CA 95678-2223

Mailing address

PO Box 7593
Citrus Heights, CA 95621-2223
Phone (916) 461-4832

Other practice location 1

4741 Engle Rd
Carmichael, CA 95608-2223
Phone (916) 977-0949

Other names 1

  • Jennifer Mount Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240528003783 CA Practitioner - Marriage and Family Therapist 4789026360 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119918CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for New Directions, Inc. CurrentSince Mar 30, 2024 Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc Clinical PastSince Dec 25, 2018 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

1100 Melody Ln
Ste 108
Roseville, CA 95678

27201 Tourney Rd
Ste 206
Valencia, CA 91355

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633219200000",
    "number": "1962941872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7593",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956212223",
            "telephone_number": "916-461-4832",
            "fax_number": "916-483-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 FOLSOM RD SUITE C",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782223",
            "telephone_number": "916-461-4832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4741 Engle Rd",
            "address_purpose": "LOCATION",
            "city": "Carmichael",
            "state": "CA",
            "postal_code": "956082223",
            "country_code": "US",
            "telephone_number": "916-977-0949",
            "fax_number": "916-483-6326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2021-10-03",
        "certification_date": "2021-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MOUNT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.