Active NPI
Shelley L. Segal, PSYD
- Clinical Psychologist
- Encino, CA
National Provider Identifier
1376793323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY20040
- Practice address
- 16550 Ventura Blvd Ste 405
Encino, CA 91436-2084 - Phone
- (818) 784-1055
- NPI assigned
- Sep 26, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY20040 | CA | Primary |
Addresses
Primary practice location
16550 Ventura Blvd Ste 405
Encino, CA 91436-2084
Mailing address
16550 Ventura Blvd Ste 405
Encino, CA 91436-2084
Phone (818) 784-1055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Nov 4, 2015 through Nov 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20040 | CA | MD | Professional Counselor |
| PSY20040 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222387200000",
"number": "1376793323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16550 VENTURA BLVD STE 405",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362084",
"telephone_number": "818-784-1055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16550 VENTURA BLVD STE 405",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362084",
"telephone_number": "818-784-1055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEGAL",
"first_name": "SHELLEY",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-26",
"last_updated": "2008-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY20040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.