Shalila Anne Douglas, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

26617 Issued in CA

Practice address

1320 E Shaw Ave Ste 150
Fresno, CA 93710-7915

Phone

(559) 221-3225

NPI assigned

Aug 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1326294661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 E SHAW AVE STE 150",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107915",
            "telephone_number": "559-221-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 E SHAW AVE STE 150",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107915",
            "telephone_number": "559-221-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "SHALILA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "26617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simon Francis Dougherty, PA-C
• Douglas O. Charters
• Douglas R Halloran DDS Inc
• Douglas R Swinehart M D Professional Corporation
• Douglas S. Stanley, M.D., Inc.
• Kimberly Douglass
• Sophia A Doukas
• Sudhakar Doule, B.PHARM
• Raymond Sam Doumanian, D.D.S.
• Wendy Doval

• Psychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.