Shannon Dubach, PSYD
NPI 1992967996ActiveIndividual· Psychologist, Clinical· Berkeley, CA
Psychologist, Clinical (PSYD) in Berkeley, California, licensed in CA, with an NPI issued in June 2008. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1992967996 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | Yes |
| NPI issued | Jun 30, 2008 |
| Last updated in NPPES | Jan 28, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PSY24793 | CA |
| Psychologist, Adult Development & Aging | 103TA0700X | PSY24793 | CA |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | PSY24793 | 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 (CA) |
|---|
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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