Shannon Shaffer Peterson, M.S.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

131678 Issued in CA

Practice address

4000 W Metropolitan Dr Ste 401
Orange, CA 92868-3506

Phone

(866) 830-6011

NPI assigned

Apr 9, 2007

Last updated

Sep 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1972626521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12851 HASTER ST APT 11D",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928406560",
            "telephone_number": "714-349-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 401",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683506",
            "telephone_number": "866-830-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHANNON",
        "middle_name": "SHAFFER",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "131678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Sue Peterson, DC
• Jennifer Delia Peterson, RN
• Kimberly Peterson, NP
• Margaret Anne Peterson, CAODC
• Melanie Peterson, MD
• Terrye Peterson, RN, CDE
• Sahnvi Sunil Pethe
• Ljubica Drina Petrasic Smith
• Anton Petrenko, PHD
• Petri Dental Corporation

• Marriage & Family Therapist in Orange, CA
• Providers in Orange, 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 Sep 23, 2024; 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.