Active NPI
Leilani Shields, PSYD
- Psychologist
- San Jose, CA
National Provider Identifier
1164169405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY26142
- Practice address
- 1 Washington SQ
San Jose, CA 95192-1000 - Phone
- (408) 924-5910
- NPI assigned
- May 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY26142 | CA | Primary |
Addresses
Primary practice location
1 Washington SQ
San Jose, CA 95192-1000
Mailing address
1 Washington SQ
San Jose, CA 95192-3738
Phone (408) 924-5910
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250331001231 | CA | Practitioner - Clinical Psychologist | 2264955293 | Practice locations: Santa Clara, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Santa Clara, CA 95051
Phone (415) 741-4990
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY26142 | CA | MD | Psychologist |
| 26142 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1164169405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WASHINGTON SQ",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951923738",
"telephone_number": "408-924-5910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WASHINGTON SQ",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951921000",
"telephone_number": "408-924-5910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "LEILANI",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-18",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY26142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.