DR. SHANNON ELYSE STOVALL LPC, PSYD
NPI 1861705188
Psychologist in Fremont, CA

Active since July 15, 2010PECOS EnrolledAccepts Medicare Assignment
39159 PASEO PADRE PKWY STE 121, FREMONT, CA 94538(510) 952-1190 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 16, 2026, Jan 3, 2022 (2 updates tracked since 2022).

About Dr. Shannon Elyse Stovall Lpc, Psyd NPPES

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

DR. SHANNON ELYSE STOVALL LPC, PSYD (NPI 1861705188) is an individual psychologist in Fremont, California, licensed in California (26755) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1861705188
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. SHANNON ELYSE STOVALLCredential: LPC, PSYD
Location Address39159 PASEO PADRE PKWY STE 121Fremont, CA 94538-1600
Mailing Address39159 Paseo Padre Pkwy Ste 121Fremont, CA 94538-1600 · (210) 542-4616
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJuly 15, 2010
Last NPPES UpdateJanuary 16, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2026
✔ NPI 1861705188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · 26755
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.
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 64885 (TX)
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 26755 (CA)
39159 PASEO PADRE PKWY STE 121, Fremont, CA 94538

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shannon Elyse Stovall Lpc, 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 ID7810213246
PECOS Enrollment IDI20150303000684
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Shannon Stovall reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Same address
Psychiatry
39159 PASEO PADRE PKWY STE 121
Fremont, CA 94538
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: 3 Prong
  • 10 clinicians in this Medicare group
Internal Medicine
1190 VETERANS BLVD
Redwood City, CA 94063
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Nurse Practitioner (Psychiatric/Mental Health)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Counselor (Mental Health)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Social Worker (Clinical)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Counselor (Professional)
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538
Marriage & Family Therapist
39159 PASEO PADRE PKWY STE 121
FREMONT, CA 94538

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 Shannon Stovall's NPI number?

The NPI number for Shannon Stovall is 1861705188. It was assigned to this individual provider in the NPPES registry on July 15, 2010.

Where is Shannon Stovall located?

Shannon Stovall practices at 39159 Paseo Padre Pkwy Ste 121, Fremont, CA 94538. The listed phone number is (510) 952-1190.

What is Shannon Stovall's specialty?

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

Is Shannon Stovall enrolled in Medicare?

Yes. Shannon Stovall 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.

Which organizations bill Medicare for Shannon Stovall's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Stovall reassigns Medicare benefits to 2 organizations: 3prong (Fremont, CA) and Permanente Medical Group Inc (Redwood City, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Stovall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shannon Stovall was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.