Active NPI
Nancy Shah, PSY. D
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1710318563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY25572
- Practice address
- 2821 Lange Ave
San Diego, CA 92122-3109 - Phone
- (858) 246-6310
- Fax
- (858) 246-7577
- NPI assigned
- Dec 4, 2013
- 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 | PSY25572 | CA | Primary |
Addresses
Primary practice location
2821 Lange Ave
San Diego, CA 92122-3109
Mailing address
2821 Lange Ave
San Diego, CA 92122-3109
Phone (858) 246-6310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25572 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386115200000",
"number": "1710318563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 LANGE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921223109",
"telephone_number": "858-246-6310",
"fax_number": "858-246-7577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 LANGE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921223109",
"telephone_number": "858-246-6310",
"fax_number": "858-246-7577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "NANCY",
"credential": "PSY. D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-04",
"last_updated": "2013-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY25572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.