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MS. JENNIFER JOY SHANNON MFC
NPI 1013982768
Counselor - Mental Health in Santa Rosa, CA

Active since February 17, 2006Opted out of Medicare · through Oct 18, 2026
613 COLLEGE AVE, SANTA ROSA, CA 95404(707) 703-5199 Get Directions Write a Review

NPPES record last updated: December 4, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ms. Jennifer Joy Shannon Mfc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. JENNIFER JOY SHANNON MFC (NPI 1013982768) is an individual mental health provider in Santa Rosa, California, licensed in California (MFC 30265) and active in the NPI registry since February 2006. She has opted out of Medicare through October 18, 2026.

NPPES Registry Identity

NPI1013982768
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. JENNIFER JOY SHANNONCredential: MFC
Location Address613 COLLEGE AVESanta Rosa, CA 95404-4104
Mailing Address613 College AveSanta Rosa, CA 95404-4104 · (707) 703-5199
Phone(707) 703-5199
Sole ProprietorYes
Enumeration DateFebruary 17, 2006
Last NPPES UpdateDecember 4, 2016
✔ NPI 1013982768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CA · MFC 30265
613 COLLEGE AVE, Santa Rosa, CA 95404
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Jennifer Joy Shannon Mfc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 18, 2024 through October 18, 2026.

Opt-Out Effective DateOctober 18, 2024
Opt-Out In Effect ThroughOctober 18, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARMEN SCHMIDT BENDETTI MA, LMFT
Marriage & Family Therapist
613 COLLEGE AVE
SANTA ROSA, CA 95404
Sonoma County (707) 331-4578
MARY LINSCOMB LCSW
Social Worker (Clinical)
613 COLLEGE AVE
SANTA ROSA, CA 95404
Sonoma County (707) 545-4600
AYLA BETH BRIDGES MS
Marriage & Family Therapist
613 COLLEGE AVE
SANTA ROSA, CA 95404
Sonoma County (707) 545-4600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Shannon's NPI number?

The NPI number for Jennifer Shannon is 1013982768. It was assigned to this individual provider in the NPPES registry on February 17, 2006.

Where is Jennifer Shannon located?

Jennifer Shannon practices at 613 College Ave, Santa Rosa, CA 95404. The listed phone number is (707) 703-5199.

What is Jennifer Shannon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jennifer Shannon enrolled in Medicare?

No. Jennifer Shannon has opted out of Medicare through October 18, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jennifer Shannon was last updated on December 4, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.