Travis Martin Shivley-Scott, PHD
NPI 1609445444ActiveIndividual· Clinical Neuropsychologist· Mather, CA
Clinical Neuropsychologist (PHD) in Mather, California, trained at Fordham University School of Medicine (class of 2019). Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1609445444 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Jun 24, 2021 |
| Last updated in NPPES | Oct 13, 2026 |
| Certified by provider | Oct 13, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinical Neuropsychologist Primary | 103G00000X | 32064 | CA |
| Psychologist, Clinical | 103TC0700X | 32064 | CA |
| Psychologist | 103T00000X | 32064 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (NM) |
|---|
Education and affiliations
| Medical school | Fordham University School of Medicine |
|---|---|
| Graduation year | 2019 |
| Medicare specialty | Clinical Psychologist |
Medical group
- Brain and Behavioral Associates, PCAlbuquerque, NM · 4 clinicians
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