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SHANNON WALLACE OTTENS LCSW
NPI 1740064229
Social Worker - Clinical in Sebastopol, CA

Active since August 24, 2023PECOS Enrolled
652 PETALUMA AVE STE H, SEBASTOPOL, CA 95472(707) 823-3166 Get Directions Write a Review

NPPES record last updated: June 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannon Wallace Ottens Lcsw NPPES

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

SHANNON WALLACE OTTENS LCSW (NPI 1740064229) is an individual clinical provider in Sebastopol, California, licensed in California (139066) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740064229
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANNON WALLACE OTTENSCredential: LCSW
Location Address652 PETALUMA AVE STE HSebastopol, CA 95472-4266
Mailing AddressPo Box 8531Santa Rosa, CA 95407-1531
Phone(707) 823-3166
Sole ProprietorNo
Enumeration DateAugust 24, 2023
Last NPPES UpdateJune 15, 2026
NPPES CertifiedJune 15, 2026
✔ NPI 1740064229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 139066
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
652 PETALUMA AVE STE H, Sebastopol, CA 95472
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Wallace Ottens Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95472 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $63.04 – $187.01
Typical copayment $0.00 (range $15.76 – $46.75)
Most-billed visit code NA
Established Patient
$77.94 typical visit price
range $21.02 – $153.40
Typical copayment $19.48 (range $5.25 – $38.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

KATHERINE ANN MILLER FNP-C
Nurse Practitioner (Family)
652 PETALUMA AVE STE H
SEBASTOPOL, CA 95472
Sonoma County (707) 823-3166
PHOEBE L SMITH M.D.
Family Medicine
652 PETALUMA AVE STE H
SEBASTOPOL, CA 95472
Sonoma County (707) 823-3166
HARRY S. SIMMS MD
Emergency Medicine
652 PETALUMA AVE STE H
SEBASTOPOL, CA 95472
Sonoma County (707) 823-3166
ANITA VASUDEVAN MD
Family Medicine
652 PETALUMA AVE STE H
SEBASTOPOL, CA 95472
Sonoma County (707) 823-3166
DANA LEVANDOSKI LCSW
Social Worker (Clinical)
652 PETALUMA AVE STE H
SEBASTOPOL, CA 95472
Sonoma County (707) 823-3166
ANN-ELIZABETH GRIEGO MD
Family Medicine
652 PETALUMA AVE STE H
SEBASTOPOL, CA 95472
Sonoma County (707) 823-3166

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 Shannon Ottens's NPI number?

The NPI number for Shannon Ottens is 1740064229. It was assigned to this individual provider in the NPPES registry on August 24, 2023.

Where is Shannon Ottens located?

Shannon Ottens practices at 652 Petaluma Ave Ste H, Sebastopol, CA 95472. The listed phone number is (707) 823-3166.

What is Shannon Ottens's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shannon Ottens enrolled in Medicare?

Yes. Shannon Ottens is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Ottens was last updated on June 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.