Active NPI
Lynn Davilla Shields, PH.D.
- Clinical Psychologist
- Lafayette, CA
National Provider Identifier
1689768665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY13805
- Practice address
- 3468 Mt Diablo Blvd
Suite B201
Lafayette, CA 94549-3957 - Phone
- (925) 283-5107
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY13805 | CA | Primary |
Addresses
Primary practice location
3468 Mt Diablo Blvd
Suite B201
Lafayette, CA 94549-3957
Mailing address
3468 Mt Diablo Blvd
Suite B201
Lafayette, CA 94549-3957
Phone (925) 283-5107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 20, 2025 through Oct 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13805 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY13805 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689768665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3468 MT DIABLO BLVD",
"address_2": "SUITE B201",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945493957",
"telephone_number": "925-283-5107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3468 MT DIABLO BLVD",
"address_2": "SUITE B201",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945493957",
"telephone_number": "925-283-5107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "LYNN",
"middle_name": "DAVILLA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY13805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, CA
Sources for this page
- 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.