Lisa Shibata

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

554692 Issued in CA

Practice address

1300 W. 7TH Street
Bridges Unit, 4 East
San Pedro, CA 90732

Phone

(310) 832-3311

NPI assigned

Mar 1, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583020800000",
    "number": "1033743984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W 7TH ST",
            "address_2": "BRIDGES UNIT, 4 EAST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W. 7TH STREET",
            "address_2": "BRIDGES UNIT, 4 EAST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-832-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBATA",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-01",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "554692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Popelka Shepard, LMFT
• Lisa J Shepard, DPT, OCS
• Kiera Dawn Shepherd, LMT
• Daniel Sherman, PH.D.
• Sherry Sonka-Maarek MD Inc
• Honoka Wendy Shiga
• Timothy Shin
• Blanca Shirale
• Shoreline Wellness Multi
• Jennifer Elizabeth Shortt, LCSW

• Psychiatric/Mental Health Registered Nurse in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.