Individual provider Active NPI

Mariela G. Shibley, PSY.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1114070992
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY23239 Issued in CA
Practice address
411 Camino del Rio S Ste 205
San Diego, CA 92108-3550
Phone
(619) 307-9346
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 PSY23239 CA Primary

Addresses

Primary practice location

411 Camino del Rio S Ste 205
San Diego, CA 92108-3550

Mailing address

411 Camino del Rio S Ste 205
San Diego, CA 92108-3550
Phone (619) 307-9346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23239CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shibley Psychology, Corp. Clinical Current Accepting new patients

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1114070992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CAMINO DEL RIO S STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083550",
            "telephone_number": "619-307-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CAMINO DEL RIO S STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083550",
            "telephone_number": "619-307-9346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBLEY",
        "first_name": "MARIELA",
        "middle_name": "G.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.