Active NPI
Bruce Robert Shafer
- Marriage & Family Therapist
- Redding, CA
National Provider Identifier
1982042164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 18593
- Practice address
- 2640 Breslauer Way
Redding, CA 96001-4246 - Phone
- (530) 225-5200
- NPI assigned
- Jun 10, 2013
- Last updated
- Jun 10, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 18593 | CA | Primary |
Addresses
Primary practice location
2640 Breslauer Way
Redding, CA 96001-4246
Mailing address
2640 Breslauer Way
Redding, CA 96001-4246
Phone (530) 225-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
Palm Springs, CA 92264
Phone (855) 241-7160
39905 Via Scena
Unit 218
Palm Desert, CA 92260-1827
Phone (855) 241-7160
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18593 | CA | MD | Clinical Neuropsychologist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Plainfield, IL
- NPI 1447678990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370822400000",
"number": "1982042164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2640 BRESLAUER WAY",
"city": "REDDING",
"state": "CA",
"postal_code": "960014246",
"telephone_number": "530-225-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2640 BRESLAUER WAY",
"city": "REDDING",
"state": "CA",
"postal_code": "960014246",
"telephone_number": "530-225-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "BRUCE",
"middle_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-10",
"last_updated": "2013-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "18593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.