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KATHERINE SHADISH PHD
NPI 1336589043
Psychologist - Clinical in San Mateo, CA

Active since June 26, 2013PECOS EnrolledAccepts Medicare Assignment
222 W 39TH AVE, SAN MATEO, CA 94403(408) 975-2730 Get Directions Write a Review

NPPES record last updated: January 15, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Katherine Shadish Phd NPPES

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

KATHERINE SHADISH PHD (NPI 1336589043) is an individual clinical provider in San Mateo, California, licensed in California (30634) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1336589043
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameKATHERINE SHADISHCredential: PHD
Location Address222 W 39TH AVESan Mateo, CA 94403-4364
Mailing Address222 W 39th AveSan Mateo, CA 94403-4364
Phone(408) 975-2730
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 26, 2013
Last NPPES UpdateJanuary 15, 2019
✔ NPI 1336589043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 30634
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
222 W 39TH AVE, San Mateo, CA 94403
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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

Katherine Shadish Phd 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 ID3779822200
PECOS Enrollment IDI20190228000756
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 94403 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.

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.

DR. LORENA MICHEL PSY.D.
Psychologist (Clinical)
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-3420
COUNTY OF SAN MATEO
General Acute Care Hospital
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-2222
DR. JUDITH CLAIRE SCHIFFNER M.D.
Dermatology
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-2414
SAN MATEO MEDICAL CENTER
Clinic/Center
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-2222
JOHN ANDERSON MD
Obstetrics & Gynecology
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-2222
MR. PAUL SAITO M.A.
Counselor
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-3435
CHRISTIAN SUSTRINA PTA
Physical Medicine & Rehabilitation
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-2222
KATHRYN JOY SANTANA RN PHN
Registered Nurse
222 W 39TH AVE
SAN MATEO, CA 94403
San Mateo County (650) 573-3982

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 Katherine Shadish's NPI number?

The NPI number for Katherine Shadish is 1336589043. It was assigned to this individual provider in the NPPES registry on June 26, 2013.

Where is Katherine Shadish located?

Katherine Shadish practices at 222 W 39th Ave, San Mateo, CA 94403. The listed phone number is (408) 975-2730.

What is Katherine Shadish's specialty?

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

Is Katherine Shadish enrolled in Medicare?

Yes. Katherine Shadish 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 Katherine Shadish was last updated on January 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.