BEHROOZ SHAFIEZADEH LMFT, APCC
NPI 1639613409
Marriage & Family Therapist in Fairfield, CA

Q: What is Behrooz Shafiezadeh's NPI number?

The NPI number for Behrooz Shafiezadeh is 1639613409. It was assigned to this individual provider in the NPPES registry on December 13, 2016.

Q: What is Behrooz Shafiezadeh's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Active since December 13, 2016PECOS EnrolledAccepts Medicare Assignment

2101 COURAGE DR, FAIRFIELD, CA 94533(707) 784-2077 Get Directions Write a Review

NPPES record last updated: June 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 1, 2023, May 9, 2023, May 3, 2023 and 3 more (6 updates tracked since 2016).

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About Behrooz Shafiezadeh Lmft, Apcc NPPES

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

BEHROOZ SHAFIEZADEH LMFT, APCC (NPI 1639613409) is an individual marriage & family therapist in Fairfield, California, licensed in California (139343) and active in the NPI registry since December 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1639613409

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameBEHROOZ SHAFIEZADEHCredential: LMFT, APCC

Location Address2101 COURAGE DRFairfield, CA 94533-6717

Mailing AddressPo Box 515Fairfield, CA 94533-0051 · (510) 219-4061

Phone(707) 784-2077

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateDecember 13, 2016

Last NPPES UpdateJune 1, 20236 updates tracked since enumeration

NPPES CertifiedJune 1, 2023

✔ NPI 1639613409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 139343

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

2101 COURAGE DR, Fairfield, CA 94533

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Other Identifiers 1

OtherC5252989CA · Driver Licence

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Behrooz Shafiezadeh Lmft, Apcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274038807

PECOS Enrollment IDI20250924004998

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

MS. JENNIFER RUTH PETTIBONE RN

Registered Nurse (Psychiatric/Mental Health)

2101 COURAGE DR, MS-10-200
FAIRFIELD, CA 94533

Solano County (707) 784-2154

MALISSA BLAIR RN

Registered Nurse