Shaina Roxanne Ponce, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY34085 Issued in CA

Practice address

2831 Camino del Rio S Ste 308
San Diego, CA 92108-3829

Phone

(619) 786-5866

NPI assigned

Nov 20, 2021

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Aviva Psychological Services, Apc

  • Cognitive & Behavioral Psychologist
  • San Diego, CA
  • NPI 1710741558

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1637366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1447917810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 CAMINO DEL RIO S STE 308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083829",
            "telephone_number": "619-786-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 CAMINO DEL RIO S STE 308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083829",
            "telephone_number": "619-786-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE",
        "first_name": "SHAINA",
        "middle_name": "ROXANNE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-20",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernie Ponce
• Flavia V Ponce
• Leah Ponce
• Lesly Ponce
• Michelle Diane Ponce, LVN
• Tahiri Ponce
• Vanessa J. Ponce, LVN
• Yzella Ponce
• Katherine Anne Ponchetti, LISW
• Jeffrey Pond

• 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 Sep 6, 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.