Shelley Gallivan, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

17816 Issued in CA

Practice address

1503 Grant Rd Ste 110
Mountain View, CA 94040-3270

Phone

(650) 484-1213

NPI assigned

Aug 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Momentum for HealthGroup PAC ID 2769377217, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgallivan80417@direct.phhs.org

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.

• Momentum for Health

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1154426807
  Medicare reassignment Care Compare group NPD
• Momentum for Health

  • Mental Illness Community Based Residential Treatment Facility
  • San Jose, CA
  • NPI 1306062799
  NPD
• Momentum for Health

  • Psychologist
  • San Jose, CA
  • NPI 1760181234
  NPD
• Midwest Neoped Associates LTD

  • Specialist
  • Oak Brook, IL
  • NPI 1396792180
  NPD (past)

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1083807606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 GRANT RD STE 110",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403270",
            "telephone_number": "650-484-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 GRANT RD STE 110",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403270",
            "telephone_number": "650-484-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIVAN",
        "first_name": "SHELLEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CA",
            "license": "17816",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IL",
            "license": "041328453",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "17816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Eugene Gallagher
• Makenzie Lee Gallego, MSW
• Jacqueline Gallegos
• Roslynn Gallegos, LCSW
• Frank C Galli, M.D.
• Yeshaben D Gandhi, DDS
• Shiveta Gandotra
• Jasmine Allegra Ganev
• Jill Vanessa Garcia, M.A., MFT, PCCI
• Leileanna Garcia

• Psychiatric/Mental Health Nurse Practitioner in Mountain View, CA
• Providers in Mountain View, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.