SHANNON GUSTAFSON MA
NPI 1912571993
Marriage & Family Therapist in Los Altos, CA

Q: What is Shannon Gustafson's NPI number?

The NPI number for Shannon Gustafson is 1912571993. It was assigned to this individual provider in the NPPES registry on May 14, 2021.

Q: What is Shannon Gustafson's specialty?

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

Q: Is Shannon Gustafson enrolled in Medicare?

No. Shannon Gustafson has opted out of Medicare through April 30, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Shannon Gustafson was last updated on May 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since May 14, 2021Opted out of Medicare · through Apr 30, 2028

851 FREMONT AVE STE 210, LOS ALTOS, CA 94024(650) 297-3400 Get Directions Write a Review

NPPES record last updated: May 14, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Shannon Gustafson Ma NPPES

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

SHANNON GUSTAFSON MA (NPI 1912571993) is an individual marriage & family therapist in Los Altos, California and active in the NPI registry since May 2021. She has opted out of Medicare through April 30, 2028.

NPPES Registry Identity

NPI1912571993

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameSHANNON GUSTAFSONCredential: MA

Location Address851 FREMONT AVE STE 210Los Altos, CA 94024-5602

Mailing Address114 S 20th StSan Jose, CA 95116-2711 · (707) 567-5886

Phone(650) 297-3400

Sole ProprietorNo

Enumeration DateMay 14, 2021

NPPES CertifiedMay 14, 2021

✔ NPI 1912571993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

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.

851 FREMONT AVE STE 210, Los Altos, CA 94024

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Shannon Gustafson Ma 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 April 30, 2024 through April 30, 2028.

Opt-Out Effective DateApril 30, 2024

Opt-Out In Effect ThroughApril 30, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 7

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

DR. ESMERALDA ADOLF PH.D

Psychologist