Active NPI
Alexandria Victoria Sheppard
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1780336602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 11549
- Practice address
- 799 Concord Ave
Cambridge, MA 02138-1048 - Phone
- (877) 626-8140
- NPI assigned
- Jan 21, 2022
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 11549 | MA | Primary |
Addresses
Primary practice location
799 Concord Ave
Cambridge, MA 02138-1048
Mailing address
115 Mill St
Belmont, MA 02478-1064
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 |
|---|---|---|---|
| 11549 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1780336602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MILL ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024781064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "799 CONCORD AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381048",
"telephone_number": "877-626-8140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "ALEXANDRIA",
"middle_name": "VICTORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-21",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "11549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.