Individual provider Active NPI

Shannon Casey, PSY 31889

  • Psychologist
  • El Cajon, CA
National Provider Identifier
1548873755
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
31889 Issued in CA
Practice address
215 W Madison Ave
El Cajon, CA 92020-3405
Phone
(619) 401-6227
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 31889 CA Primary

Addresses

Primary practice location

215 W Madison Ave
El Cajon, CA 92020-3405

Mailing address

13924 Barrymore St
San Diego, CA 92129-3116
Phone (619) 248-3030

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
I20201116000534 CA Practitioner - Clinical Psychologist 8426477217 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31889CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Sep 1, 2020 Accepting new patients
Grow Healthcare Group PC Psychologist CurrentSince Nov 1, 2022 Accepting new patients
Neighborhood Healthcare CurrentSince Sep 1, 2020 Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

425 N Date St
#0
Escondido, CA 92025

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1548873755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13924 BARRYMORE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293116",
            "telephone_number": "619-248-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203405",
            "telephone_number": "619-401-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "SHANNON",
        "credential": "PSY 31889",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "31889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.