Active NPI
Michael Don Shore, PH D
- Psychologist
- San Francisco, CA
National Provider Identifier
1063526192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 6837
- Practice address
- 1947 Divisadero St
Suite 5
San Francisco, CA 94115 - Phone
- (415) 751-0316
- NPI assigned
- Aug 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY 6837 | CA | |
| Psychologist | 103T00000X | PSY 6837 | CA | Primary |
Addresses
Primary practice location
1947 Divisadero St
Suite 5
San Francisco, CA 94115
Mailing address
107 14TH Avenue
San Francisco, CA 94118
Phone (415) 751-0316
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 6837 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1063526192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 14TH AVENUE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94118",
"telephone_number": "415-751-0316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1947 DIVISADERO ST",
"address_2": "SUITE 5",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94115",
"telephone_number": "415-751-0316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORE",
"first_name": "MICHAEL",
"middle_name": "DON",
"name_prefix": "Dr.",
"credential": "PH D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY 6837",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 6837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.