Shawn Lee Fruge, PSY18275

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

PSY18275 Issued in CA

Practice address

1300 Clay St Ste 600
Oakland, CA 94612-1427

Phone

(888) 345-0934

NPI assigned

Sep 9, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Psychiatry

  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Psychiatry

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1750117776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 CLAY ST STE 600",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121427",
            "telephone_number": "888-345-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CLAY ST STE 600",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121427",
            "telephone_number": "888-345-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUGE",
        "first_name": "SHAWN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY18275",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "PSY18275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel B Fronczak, PSY.D.
• Patricia Agnes Fronda
• Front Porch Communities and Services
• Sherae Frost, RASI
• Jessika Fruchter
• Fruge' Psychological Associates, Inc.
• Magalie M Fruhinsholz
• Fruits of Labor, LLC
• Fruitvale Avenue Pharmacy Inc
• Fruitvale Long Term Care LLC

• Psychiatry Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.