Active NPI
Shamiron Bales, PHD
- Psychologist
- La Jolla, CA
National Provider Identifier
1962266973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34832
- Practice address
- 3252 Holiday CT Ste 114
La Jolla, CA 92037-0027 - Phone
- (619) 380-0508
- NPI assigned
- Feb 9, 2024
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 34832 | CA | Primary |
Addresses
Primary practice location
3252 Holiday CT Ste 114
La Jolla, CA 92037-0027
Mailing address
3252 Holiday CT Ste 114
La Jolla, CA 92037-0027
Phone (619) 380-0508
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34832 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bales Psychology Clinic | Psychologist | Current | Accepting new patients |
Locations
3252 Holiday Ct
Ste 114
La Jolla, CA 92037
Phone (619) 380-0508
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741219200000",
"number": "1962266973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3252 HOLIDAY CT STE 114",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920370027",
"telephone_number": "619-380-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3252 HOLIDAY CT STE 114",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920370027",
"telephone_number": "619-380-0508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALES",
"first_name": "SHAMIRON",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-09",
"last_updated": "2025-03-06",
"certification_date": "2025-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "34832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.