Active NPI
Andrea Shelley, PSY-D
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1922349612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY20375
- Practice address
- 1757 Union St
San Francisco, CA 94123-4447 - Phone
- (415) 515-3211
- Fax
- (714) 739-4008
- NPI assigned
- Mar 6, 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 | PSY20375 | CA | Primary |
Addresses
Primary practice location
1757 Union St
San Francisco, CA 94123-4447
Mailing address
PO Box 330251
San Francisco, CA 94133-0251
Phone (415) 515-3211
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 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20375 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1922349612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 330251",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941330251",
"telephone_number": "415-515-3211",
"fax_number": "714-739-4008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1757 UNION ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941234447",
"telephone_number": "415-515-3211",
"fax_number": "714-739-4008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLEY",
"first_name": "ANDREA",
"credential": "PSY-D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-06",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY20375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.