Individual provider Active NPI

Shawn Grant, AMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1992579957
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
141893 Issued in CA
Practice address
8885 Rio San Diego Dr Ste 301
San Diego, CA 92108-1610
Phone
(619) 345-4611
NPI assigned
Nov 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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 141893 CA Primary

Addresses

Primary practice location

8885 Rio San Diego Dr Ste 301
San Diego, CA 92108-1610

Mailing address

7964 Mission Bonita Dr
San Diego, CA 92120-1547
Phone (760) 504-2470

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

LicenseStateTypeSpecialty
141893CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Steven a. Cohen Military Family Clinic at VVSD, San Diego CurrentSince Nov 12, 2023 Accepting new patients

Locations

8885 Rio San Diego Dr
Ste 301
San Diego, CA 92108
Phone (619) 345-4611

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1992579957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7964 MISSION BONITA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921201547",
            "telephone_number": "760-504-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR STE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081610",
            "telephone_number": "619-345-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "SHAWN",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.