Shannon Elyse Stovall, LPC, PSYD
NPI 1861705188ActiveIndividual· Psychologist· Fremont, CA
Psychologist (LPC, PSYD) with 3 Prong, practicing in Fremont, California. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1861705188 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPC, PSYD |
| Sole proprietor | No |
| NPI issued | Jul 15, 2010 |
| Last updated in NPPES | Jan 16, 2026 |
| Certified by provider | Jan 16, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 26755 | CA |
| Psychologist, Counseling | 103TC1900X | 26755 | CA |
| Counselor, Professional | 101YP2500X | 64885 | TX |
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 (CA) |
|---|
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- 3 ProngFremont, CA · 7 clinicians
Other Psychologist providers in Fremont
- 1720379613
- 1427721216
- 1629593611
- 1164018883
- 1174955801
- 1285808915
- 1134490725
- 1568531580
- 1194965327
- 1386895787
- 1487918231
- 1306195979