Active NPI
Jeffrey David Shein, PH.D.
- Forensic Psychologist
- Coalinga, CA
National Provider Identifier
1114070240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- PSY11865
- Practice address
- 24511 West Jayne Avenue
Coalinga, CA 93210 - Phone
- (559) 935-4300
- Fax
- (559) 935-4308
- NPI assigned
- Jan 20, 2007
- 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 Psychologist | 103TC0700X | PSY11865 | CA | |
| Forensic Psychologist | 103TF0200X | PSY11865 | CA | Primary |
Addresses
Primary practice location
24511 West Jayne Avenue
Coalinga, CA 93210
Mailing address
PO Box 5000
Coalinga, CA 93210-5000
Phone (559) 935-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY118650 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11865 | CA | MD | Forensic Psychologist |
| 11865 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382659200000",
"number": "1114070240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5000",
"city": "COALINGA",
"state": "CA",
"postal_code": "932105000",
"telephone_number": "559-935-4300",
"fax_number": "559-935-4308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24511 WEST JAYNE AVENUE",
"city": "COALINGA",
"state": "CA",
"postal_code": "93210",
"telephone_number": "559-935-4300",
"fax_number": "559-935-4308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEIN",
"first_name": "JEFFREY",
"middle_name": "DAVID",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-20",
"last_updated": "2013-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY11865",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "PSY11865",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY118650",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coalinga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.