Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shital Pavawalla, PHD

Individual provider Clinical Neuropsychologist · NPI 1336400357

Dr. Shital Pavawalla, PHD is a Clinical Psychologist in Los Angeles, California. Qualified in 2009, 17 years ago. Practices with Kandm Neuropsychology, a Psychology Corporation, a 12-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
17
Licensed in
CA
In the registry since
2012
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

300 Medical Plz # B200
Los Angeles, CA 90095-6361
Phone: (310) 794-1195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 8700 Beverly Blvd, West Hollywood, CA 90048-1804 — (310) 423-9722
  • 9909 Medical Center Dr, Rockville, MD 20850-6361 — (240) 864-6007

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 24673 (CA)

Record details

NPI number1336400357
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 6, 2012
Last updated in NPPESSeptember 16, 2020
Certification dateSeptember 16, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Kandm Neuropsychology, A Psychology Corporation — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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