SHADI EBRAHIM LMFT
NPI 1932995628
Counselor - Mental Health in Rancho Cucamonga, CA
About Shadi Ebrahim Lmft NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHADI EBRAHIM LMFT (NPI 1932995628) is an individual mental health provider in Rancho Cucamonga, California, licensed in California (163334) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shadi Ebrahim Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shadi Ebrahim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Jose, CA 95113
- Reassigned Medicare billing, California enrollment
- 3,139 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
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 Shadi Ebrahim's NPI number?
The NPI number for Shadi Ebrahim is 1932995628. It was assigned to this individual provider in the NPPES registry on April 17, 2025.
Where is Shadi Ebrahim located?
Shadi Ebrahim practices at 9065 Haven Ave Ste 110, Rancho Cucamonga, CA 91730. The listed phone number is (909) 757-5770.
What is Shadi Ebrahim's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Shadi Ebrahim enrolled in Medicare?
Yes. Shadi Ebrahim is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Shadi Ebrahim's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shadi Ebrahim reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shadi Ebrahim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shadi Ebrahim was last updated on July 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Shadi Ebrahim, LMFT · NPI 1932995628
Mental Health provider in Rancho Cucamonga, California. Individual provider, active in the CMS NPPES registry since April 17, 2025.
## Identity
- **NPI:** 1932995628 (Entity type: Individual)
- **Enumerated:** April 17, 2025
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 163334 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 9065 HAVEN AVE STE 110, Rancho Cucamonga, CA 91730-5429
- **Phone:** (909) 757-5770
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PC (NPI 1154994846, San Jose, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** July 2, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1932995628) · Data from the CMS NPPES public registry.