Individual provider Active NPI

Elizabeth Shon, PH.D

  • Psychologist
  • Pasadena, CA
National Provider Identifier
1487706248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY11520 Issued in CA
Practice address
745 S Marengo Ave
Pasadena, CA 91106-4735
Phone
(626) 793-0858
Fax
(323) 256-8203
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY11520 CA Primary

Addresses

Primary practice location

745 S Marengo Ave
Pasadena, CA 91106-4735

Mailing address

745 S Marengo Ave
Pasadena, CA 91106-4735
Phone (626) 793-0858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081202000369 CA Practitioner - Clinical Psychologist 5395806962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

745 S Marengo Ave
Suite 105
Pasadena, CA 91106-4738
Phone (626) 793-0858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487706248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 S MARENGO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911064735",
            "telephone_number": "626-793-0858",
            "fax_number": "323-256-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 S MARENGO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911064735",
            "telephone_number": "626-793-0858",
            "fax_number": "323-256-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHON",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY11520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.