Junichi Shimaoka

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29143 Issued in CA

Practice address

100 S Ellsworth Ave Ste 802
San Mateo, CA 94401-3926

Phone

(650) 667-7193

NPI assigned

Jun 28, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Banyan Psychology Inc.

  • Clinical Psychologist
  • Burlingame, CA
  • NPI 1386336501
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1003267329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE STE 802",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013926",
            "telephone_number": "650-667-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE STE 802",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013926",
            "telephone_number": "650-667-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMAOKA",
        "first_name": "JUNICHI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baley Wyatt Shields
• Aileen Shieu, MD
• Lori Marie Shiffer, CTRS
• Takashi Shigihara, D.D.S.
• Yumeto Shigihara, DDS
• Haeri Shin
• Anne Shing
• Shirin Shahinfar Imani DDS Inc
• Samiko Shiroma, LMFT
• Paul Shiu

• Clinical Psychologist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.