Shannon Marie Bates, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29907 Issued in CA

Practice address

760 Westwood PLZ Ste 48-240
Los Angeles, CA 90024-5055

Phone

(310) 825-0586

NPI assigned

Apr 13, 2018

Last updated

Jul 19, 2024By the provider in NPPES

Sex

Female

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

Enrolled in CA

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 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.32 of 100Reported as group

Quality

76.01

Promoting interoperability

100

Improvement activities

40

Cost

56.17

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• UC Regents

  dba UCLA Neuropsychiatric Behavioral Health

  • Adult Development & Aging Psychologist
  • Los Angeles, CA
  • NPI 1750368999

  Clinical

  Medicare reassignment NPD
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248
  NPD (past)

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1073000279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ STE 48-240",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "310-825-0586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Westwood Plz Ste 47-438C",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958353",
            "country_code": "US",
            "telephone_number": "310-267-3377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATES",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Bates, M.D.
• Maria Bates, NURSE PRACTITIONER
• Rickey Bates, LCSW
• Rochelle Bates
• Sabrina Salomon Bates, FNP
• Sharese Bates
• Stephanie Bates
• David Scott Bateshansky, PHARM.D.
• Eraka Patty Jene Bath, MD
• Alexis Gabrielle Batiste

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.