Gail M. Shak, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PSY10401 Issued in CA

Practice address

405 Primrose Rd
Suite 205
Burlingame, CA 94010-4064

Phone

(650) 375-1588

Fax

(650) 548-1589

NPI assigned

Feb 19, 2007

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

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2013 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467596510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 PRIMROSE RD",
            "address_2": "SUITE 205",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104064",
            "telephone_number": "650-375-1588",
            "fax_number": "650-548-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 PRIMROSE RD",
            "address_2": "SUITE 205",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104064",
            "telephone_number": "650-375-1588",
            "fax_number": "650-548-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAK",
        "first_name": "GAIL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY10401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire M Serrato, MD
• Ana Patricia Severo
• Chandni Raj Shah
• Sagar Prakash Shah, MD, MPH
• Sonia Shah, M.D.
• Sarah Shalev, M.D.
• Neil Nitin Shankar, AMFT
• Debra Shapiro, M.D.
• Elizabeth Lynn Shargel
• Thomas Edward Shaughnessy, MD

• Counseling Psychologist in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Counseling Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.