Shanda M Angioli, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30699 Issued in CA

Practice address

4640 Cass St # 90422
San Diego, CA 92109-2804

Phone

(858) 274-0874

NPI assigned

Feb 6, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• San Diego Forensic Psychology Corporation

  • Forensic Psychologist
  • San Diego, CA
  • NPI 1538620786
  NPD Authorized official
• Pasadena Clinical Group, a Psychology Corporation

  • Psychologist
  • Pasadena, CA
  • NPI 1790213247

  Clinical

  NPD (past)

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1265997936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90422",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921692422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 CASS ST # 90422",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092804",
            "telephone_number": "858-274-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGIOLI",
        "first_name": "SHANDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY30699",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angels Foster Family Agency
• Angels Helpful Hands LLC
• Jennifer Anger, MD
• Chiyori Angevine
• James Angiano
• Abigail Candare Angkaw, PH.D.
• Maria Socorro Angle
• Erin Anglikowski
• Helen Paige Anglin
• Leizyl Dela Cruz Anglo, RN, PHN

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.