Individual provider Active NPI

Qiaoyun Shi, MD, PHD

  • Child & Adolescent Psychiatry Physician
  • El Monte, CA
National Provider Identifier
1083158075
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
163297 Issued in CA
Practice address
9864 Baldwin PL
El Monte, CA 91731-2202
Phone
(626) 433-1311
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 008961 GA
Child & Adolescent Psychiatry Physician 2084P0804X 163297 CA Primary

Addresses

Primary practice location

9864 Baldwin PL
El Monte, CA 91731-2202

Mailing address

9864 Baldwin PL
El Monte, CA 91731-2202
Phone (626) 433-1311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917002635 CA Practitioner - Psychiatry 5294153540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

9864 Baldwin PL
El Monte, CA 91731-2202
Phone (626) 433-1311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
163297CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Mar 27, 2023 Accepting new patients
Pacific Clinics CurrentSince Jun 20, 2025 Accepting new patients
Pacific Clinics CurrentSince Jun 20, 2025 Accepting new patients
Pacific Clinics Current Accepting new patients
Permanente Medical Group Inc Psychiatry CurrentSince Mar 27, 2023 Accepting new patients

Locations

3454 Hillcrest Ave
Antioch, CA 94531
Phone (925) 777-6300

800 S Santa Anita Ave
Arcadia, CA 91006
Phone (626) 254-5043

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

9864 Baldwin Pl
El Monte, CA 91731
Phone (626) 433-1316

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1083158075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9864 BALDWIN PL",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312202",
            "telephone_number": "626-433-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9864 BALDWIN PL",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312202",
            "telephone_number": "626-433-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "QIAOYUN",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "008961",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "163297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.