Dr. Shay L Groenewold, Ph.D.

Psychologist, Clinical in Vista, CA. Individual provider (NPI-1).

NPI number1013201433

StatusActive

Last updated in NPPESMay 5, 2021

Details

NPI: 1013201433
Entity type: Individual (NPI-1)
Name: Dr. Shay L Groenewold
Credential: Ph.D.
Sex: Female
Sole proprietor: Yes
Enumeration date: Jun 2, 2011
Certification date: May 5, 2021
Last updated: May 5, 2021

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - CLINICAL PSYCHOLOGIST
Can order and refer: Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
103TC0700X	Psychologist, Clinical	PSY32538	CA	Yes
101YM0800X	Counselor, Mental Health	–	–

Practice location

440 S Melrose Dr Ste 250
Vista, CA 92081-6672

Phone 760-392-1965

Mailing address

440 S Melrose Dr Ste 250
Vista, CA 92081-6672

Phone 760-392-1965

Other practice locations

1738 S Tremont St
Oceanside, CA 92054-5309

Phone 760-439-2800

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Clinical Psychologist providers in Vista, CA

All 26 Clinical Psychologist providers in Vista · All 2,587 providers in Vista

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