DR. TRACY DENISE SHAW (NPI# 1982727392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982727392 |
| Entity Type | Individual |
| Full Name | DR. TRACY DENISE SHAW |
| Credential | PH.D. |
| Practice Address |
5855 Green Valley Cir Suite 109 Culver City CA 90230-6946 |
| Practice Telephone | 3106413600 |
| Mailing Telephone | 3106413600 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
PSY 12548 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548320096 | Tracy A Shaw | Speech-Language Pathologist | 1806 W Pampa Ave, Mesa, AZ 85202-8013 | 2006-12-12 |
| 1376103002 | Tracy Shaw | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2019-06-14 |
| 1730691122 | Tracy Shaw | Nurse Practitioner | 2055 Hospital Dr Ste 340, Batavia, OH 45103-1978 | 2017-10-25 |
| 1629514633 | Tracy Shaw | Counselor | 4100 Barbara Loop Se, Rio Rancho, NM 87124-1000 | 2017-01-13 |
| 1306868526 | Tracy Lynne Shaw | Pediatrics | 605 E Jefferson St, Iowa City, IA 52245-2426 | 2006-07-24 |
| Street Address |
5855 GREEN VALLEY CIR SUITE 109 |
| City | CULVER CITY |
| State | CA |
| Zip Code | 90230-6946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548343908 | Health Development Services | Psychologist | 5855 Green Valley Cir, Suite 101, Culver City, CA 90230-6946 | 2006-10-21 |
| 1376840330 | Pamela Elaine Ashe | Psychologist | 5855 Green Valley Cir, Suite 202, Culver City, CA 90230-6946 | 2011-02-26 |
| 1205161759 | Kristen L Zaleski | Social Worker | 5855 Green Valley Cir, Culver City, CA 90230-6946 | 2009-10-15 |
| 1821160995 | Kimani Norrington-sands | Psychologist | 5855 Green Valley Cir, Suite 109, Culver City, CA 90230-6946 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558822064 | Smilemax Dental Center | Dentist | 10814 Jefferson Blvd. #g, Culver City, CA 90230 | 2019-03-27 |
| 1023532595 | Mary Alice Haye | Marriage & Family Therapist | 550 S. Vermont Ave., 7th Floor, 700, Los Angeles, CA 90230 | 2017-07-27 |
| 1902342074 | Dorene Lehavi | Social Worker | 5106 S Slauson Ave, Suite 192, Los Angeles, CA 90230 | 2017-01-13 |
| 1548634553 | Kimberly Henck | Speech-Language Pathologist | 607 Bristol Pkwy, Ste 105, Culver City, CA 90230 | 2015-11-15 |
| 1346628898 | Stephan Sepernia | Marriage & Family Therapist | 5601 W. Slavson Ave. #192, Culver City, CA 90230 | 2015-05-15 |
| 1558749291 | Sean Steven Mcknee | Chiropractor | 5839 Green Valley Cir Ste 102, Culver City, CA 90230 | 2015-05-14 |
| 1821484841 | Jasmine Lee | Family Medicine | 6000 Sepulveda Blvd Ste E10, Culver City, CA 90230 | 2015-04-07 |
| 1043609191 | Carrie Mays | Counselor | 4760 Sepulvda Blvd., Culver City, CA 90230 | 2015-01-13 |
| 1457759375 | Monquenta Felicia Young | Case Manager/Care Coordinator | 666 Green Valley Circle, Culver City, CA 90230 | 2014-12-09 |
| 1972902724 | Shana Chan Pope | Marriage & Family Therapist | 11949 Jefferson Blvd #106, Culver City, CA 90230 | 2014-08-18 |
| Find all providers in zip 90230 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770985004 | M2 Creative | Psychologist | 6715 Melrose Ave, Los Angeles, CA 90038-3411 | 2014-09-18 |
| 1508294083 | Silverlining Psychiatry Medical Group | Psychologist | 3252 Holiday Ct Ste 108, La Jolla, CA 92037-1807 | 2013-10-21 |
| 1235408089 | Behavioral Research Specialists, LLC | Psychologist | 230 N. Maryland Ave, #309, Glendale, CA 91206 | 2011-12-23 |
| 1730342957 | United Behavioral Center, Inc | Psychologist | 834 W Avenue J, Lancaster, CA 93534-3427 | 2008-07-08 |
| 1528245917 | Claude E. Arnett | Psychologist | 403 N Susan St, Santa Ana, CA 92703-3433 | 2008-01-28 |
| 1811102908 | Mary Ann Barr | Psychologist | 277 Cascade Dr, Mill Valley, CA 94941-5025 | 2007-05-11 |
| 1255544557 | Pituck Medical Group, Inc. | Psychologist | 5858 Magnolia Ave Ste C, Riverside, CA 92506-1886 | 2007-05-07 |
| 1932320389 | Ricque L. Brister | Psychologist | 56 Hanover Ln, Suite., 100, Chico, CA 95973-7230 | 2007-05-02 |
| 1013539121 | Sally Kei Mason | Psychologist | 510 Plaza Dr Ste 170, Folsom, CA 95630-4790 | 2020-05-12 |
| 1043691025 | New Day Institute | Psychologist | 6391 Magnolia Ave, Suite A, Riverside, CA 92506-2424 | 2015-06-15 |
| Find all providers with the same taxonomy | ||||
| City | CULVER CITY |
| Zip Code | 90230 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.