Individual provider Active NPI

Sheetal Siledar-Lee

  • Clinical Psychologist
  • Oakland, CA
National Provider Identifier
1578939039
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33330 Issued in CA
Practice address
510 16TH St
Oakland, CA 94612-1520
Phone
(510) 357-5515
NPI assigned
Aug 18, 2015
Last updated
May 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 33330 CA Primary

Addresses

Primary practice location

510 16TH St
Oakland, CA 94612-1520

Mailing address

1850 Gateway Blvd #900
Cocord, CA 94520
Phone (925) 825-4700

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
I20220621002112 CA Practitioner - Clinical Psychologist 7416336540 Reassigns benefits to 1 organization
Practice locations: Fremont, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bay Area Community HealthGroup PAC ID 1658349824, shared by 11 NPIs, 106 clinicians

Practice addresses (Care Compare)

Fremont, CA 94536
Phone (510) 610-8895

9460 N Name Uno
Suite 110
Gilroy, CA 95020-3536
Phone (408) 729-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33330CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Portia Bell Hume Behavioral Health & Training Center CurrentSince Jun 1, 2022 Accepting new patients
Portia Bell Hume Behavioral Health and Training Center Current Accepting new patients
Portia Bell Hume Behavioral Health and Training Center CurrentSince Jun 1, 2022 Accepting new patients
Pasadena Clinical Group, a Psychology Corporation Clinical Past Accepting new patients

Locations

1333 Willow Pass Rd
Ste 102
Concord, CA 94520
Phone (925) 338-7928

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1578939039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY BLVD #900",
            "city": "COCORD",
            "state": "CA",
            "postal_code": "94520",
            "telephone_number": "925-825-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121520",
            "telephone_number": "510-357-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILEDAR-LEE",
        "first_name": "SHEETAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.