Shama Beth Chaiken, PH.D.
Individual provider Active NPI Clinical Psychologist · Cameron Park, CA
NPI 1003042763 · NPPES record last updated May 1, 2018
Key facts
- NPI
- 1003042763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY14901 (CA)
- Practice address
- 3330 Heights Dr Ste 120
Cameron Park, CA 95682-7769 - Phone
- (530) 677-4404
- Fax
- (530) 677-4545
- NPI assigned
- Jun 8, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Rose-Marie Y. Nieto
Practice addresses (Care Compare)
3330 Heights Dr
Suite 120
Cameron Park, CA 95682-7769
Phone (530) 677-4404
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170208001364 | CA | Practitioner - Clinical Psychologist | 8224311774 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY14901 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cameron Park Counseling Center | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY14901 | CA | Yes |
Addresses
Primary practice location
3330 Heights Dr Ste 120
Cameron Park, CA 95682-7769
Mailing address
5103 Clarion CT
Placerville, CA 95667-8668
Phone (530) 957-4852
Other providers in Cameron Park, CA
- Cancer and Blood Specialty Clinic
- Breanna Canclini
- Dennis Kevin Caskey
- Janey Arlene Caylor
- Center for Functional & Integrative Medicine, Inc
- Allen Earl Chantry
- Helen Yen-Hwa Cheng
- Wai Kan Chiu
- Lauren Chong
- CHW Medical Foundation
All providers in Cameron Park, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.