Individual provider Active NPI

Shirley Harmon, PSY.D.

  • Clinical Psychologist
  • Santa Ana, CA
National Provider Identifier
1104859982
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20198 Issued in CA
Practice address
200 W Santa Ana Blvd Ste 801
Santa Ana, CA 92701-4134
Phone
(714) 704-5900
Fax
(714) 978-3419
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY20198 CA Primary

Addresses

Primary practice location

200 W Santa Ana Blvd Ste 801
Santa Ana, CA 92701-4134

Mailing address

200 W Santa Ana Blvd Ste 801
Santa Ana, CA 92701-4134
Phone (714) 704-5900

Other practice location 1

1666 N Main St
Suite 400
Santa Ana, CA 92701-7417
Phone (714) 704-5900

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

State licenses

LicenseStateTypeSpecialty
PSY20198CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Youth Services CurrentSince Jul 24, 2022 Accepting new patients

Locations

200 W Santa Ana Blvd
Ste 801
Santa Ana, CA 92701
Phone (714) 704-5900

Organizations & group practices 1

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104859982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W SANTA ANA BLVD STE 801",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014134",
            "telephone_number": "714-704-5900",
            "fax_number": "714-978-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W SANTA ANA BLVD STE 801",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014134",
            "telephone_number": "714-704-5900",
            "fax_number": "714-978-3419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1666 N Main St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927017417",
            "country_code": "US",
            "telephone_number": "714-704-5900",
            "fax_number": "714-978-3419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARMON",
        "first_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.