Domonique Casper Shaw, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

3401 Beech St
Sacramento, CA 95652

Phone

(169) 640-8050

NPI assigned

Jul 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Domonique Renee Casper Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Hisham Soliman MD Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Folsom, CA
  • NPI 1700199080
  NPD

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1033561501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 COLUMBIA AVE",
            "address_2": "APT 5",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940854481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 BEECH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95652",
            "telephone_number": "169-640-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "DOMONIQUE",
        "middle_name": "CASPER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMONIQUE",
            "last_name": "CASPER",
            "middle_name": "RENEE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayellia Shaw Lansdowne
• Brittany Shaw Stoker
• Brandon Robert Shaw
• David James Fu Shaw
• Diana Gail Shaw
• Gail Naomi Shaw, M.D.
• Galen Wayne Shaw Jr.
• Heather Rene Shaw
• I-Tsyr Shaw, MD
• Itien Emily Shaw, DDS, MD

• Psychologist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.