DR. WILLIAM MACK SHANNON PH.D.
NPI 1063668275
Psychologist - Clinical in Oakland, CA

Q: What is William Shannon's NPI number?

The NPI number for William Shannon is 1063668275. It was assigned to this individual provider in the NPPES registry on August 7, 2008.

Q: What is William Shannon's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for William Shannon was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 07, 2008PECOS EnrolledAccepts Medicare Assignment

625 16TH ST UNIT 401, OAKLAND, CA 94612(510) 290-6203 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. William Mack Shannon Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WILLIAM MACK SHANNON PH.D. (NPI 1063668275) is an individual clinical provider in Oakland, California, licensed in California (PSY22103) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1063668275

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. WILLIAM MACK SHANNONCredential: PH.D.

Location Address625 16TH ST UNIT 401Oakland, CA 94612-2180

Mailing Address625 16th St Unit 401Oakland, CA 94612-2180 · (619) 817-9309

Phone(510) 290-6203

Sole ProprietorYes

Medical School CMSOtherGraduated 1991

Enumeration DateAugust 7, 2008

Last NPPES UpdateSeptember 27, 2024

NPPES CertifiedSeptember 27, 2024

✔ NPI 1063668275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · PSY22103

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

625 16TH ST UNIT 401, Oakland, CA 94612

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. William Mack Shannon Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638204761

PECOS Enrollment IDI20100315000885

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$202.35 typical visit price

range $69.00 – $202.35

Typical copayment $50.58 (range $17.25 – $50.58)

Most-billed visit code 99205

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is William Shannon's NPI number?

The NPI number for William Shannon is 1063668275. It was assigned to this individual provider in the NPPES registry on August 7, 2008.

Where is William Shannon located?

William Shannon practices at 625 16th St Unit 401, Oakland, CA 94612. The listed phone number is (510) 290-6203.

What is William Shannon's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is William Shannon enrolled in Medicare?

Yes. William Shannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for William Shannon was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.