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

Dr. William Mack Shannon, PHD

Individual provider Clinical Psychologist · NPI 1063668275

Dr. William Mack Shannon, PHD is a Clinical Psychologist in Oakland, California. Qualified in 1991, 35 years ago. Practices with Ehab Yacoub MD Inc, a 175-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
35
Licensed in
CA
In the registry since
2008
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

625 16th St Unit 401
Oakland, CA 94612-2180
Phone: (510) 290-6203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY22103 (CA)

Record details

NPI number1063668275
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedAugust 7, 2008
Last updated in NPPESSeptember 27, 2024
Certification dateSeptember 27, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Group practice Ehab Yacoub Md Inc — 175 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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