Shay L Groenewold, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY32538 Issued in CA

Practice address

440 S Melrose Dr Ste 250
Vista, CA 92081-6672

Phone

(760) 392-1965

NPI assigned

Jun 2, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
• devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
• devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1013201433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 S MELROSE DR STE 250",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816672",
            "telephone_number": "760-392-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 S MELROSE DR STE 250",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816672",
            "telephone_number": "760-392-1965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1738 S Tremont St",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920545309",
            "country_code": "US",
            "telephone_number": "760-439-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROENEWOLD",
        "first_name": "SHAY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsi Leigh Greider-Sideris, M.D.
• Bradley William Greider, MD
• Bobby Devale Griffin
• Tyler Griffin
• Jeffrey Bryne Griffy, MFT
• Karen E Gross
• Jay Robert Grove, M.D.
• Vicki Ferrone Grove, MA, LMFT
• Holly Grow
• Guajome Learning Centers

• Clinical Psychologist in Vista, CA
• Providers in Vista, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.