Active NPI
Shantal Sheppard
- Counseling Psychologist
- San Mateo, CA
National Provider Identifier
1750277554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY24366
- Practice address
- 29 Baywood Ave
San Mateo, CA 94402-1516 - Phone
- (650) 235-7940
- NPI assigned
- Jun 17, 2025
- Last updated
- Jun 17, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY24366 | CA | Primary |
Addresses
Primary practice location
29 Baywood Ave
San Mateo, CA 94402-1516
Mailing address
250 W Jackson St Apt 32
Hayward, CA 94544-1825
Phone (341) 895-2939
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 |
|---|---|---|---|
| PSY24366 | CA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1750277554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 W JACKSON ST APT 32",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945441825",
"telephone_number": "341-895-2939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BAYWOOD AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944021516",
"telephone_number": "650-235-7940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "SHANTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-17",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY24366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.