Kelly Showen, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35288 Issued in CA

Practice address

845 El Camino Real
Menlo Park, CA 94025-4807

Phone

(650) 762-8352

NPI assigned

Aug 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 25, 2024 through Nov 25, 2026

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Pacific Anxiety Group

  • Cognitive & Behavioral Psychologist
  • Menlo Park, CA
  • NPI 1144562828
  NPD (past)

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1316771256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254807",
            "telephone_number": "650-762-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWEN",
        "first_name": "KELLY",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Shieh
• Nicole Shiloff, PH.D.
• Jien Shim, M.D.
• Graciela Shimizu Oliva, DDS, MSD
• Margaret Chin Whai Shor, OTR/L
• Nathaniel Shrake, CTRS
• Lisa Shumway
• Kareen Sicangco
• Sara Siegal, ATC
• Annette Catherine Cholon Siegel, MD

• Clinical Psychologist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.