LEILANI SHIELDS PSYD
NPI 1164169405
Psychologist in San Jose, CA

Active since May 18, 2022PECOS EnrolledAccepts Medicare Assignment
1 WASHINGTON SQ, SAN JOSE, CA 95192(408) 924-5910 Get Directions Write a Review

NPPES record last updated: June 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 1, 2023, May 18, 2022 (2 updates tracked since 2022).

About Leilani Shields Psyd NPPES

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

LEILANI SHIELDS PSYD (NPI 1164169405) is an individual psychologist in San Jose, California, licensed in California (PSY26142) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1164169405
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameLEILANI SHIELDSCredential: PSYD
Location Address1 WASHINGTON SQSan Jose, CA 95192-1000
Mailing Address1 Washington SqSan Jose, CA 95192-3738 · (408) 924-5910
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateMay 18, 2022
Last NPPES UpdateJune 1, 20232 updates tracked since enumeration
NPPES CertifiedJune 1, 2023
NPI 1164169405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY26142
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1 WASHINGTON SQ, San Jose, CA 95192

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

Leilani Shields Psyd 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 ID2264955293
PECOS Enrollment IDI20250331001231
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
1 WASHINGTON SQ
SAN JOSE, CA 95192
Specialist/Technologist (Athletic Trainer)
1 WASHINGTON SQ
SAN JOSE, CA 95192
Psychologist (Clinical)
1 WASHINGTON SQ
SAN JOSE, CA 95192
Psychologist (Clinical)
1 WASHINGTON SQ
SAN JOSE, CA 95192
Psychologist
1 WASHINGTON SQ
SAN JOSE, CA 95192
Psychologist
1 WASHINGTON SQ
SAN JOSE, CA 95192
Family Medicine
1 WASHINGTON SQ
SAN JOSE, CA 95192
Speech-Language Pathologist
1 WASHINGTON SQ
SAN JOSE, CA 95192

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 Leilani Shields's NPI number?

The NPI number for Leilani Shields is 1164169405. It was assigned to this individual provider in the NPPES registry on May 18, 2022.

Where is Leilani Shields located?

Leilani Shields practices at 1 Washington Sq, San Jose, CA 95192. The listed phone number is (408) 924-5910.

What is Leilani Shields's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Leilani Shields enrolled in Medicare?

Yes. Leilani Shields 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 Leilani Shields was last updated on June 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.