Tyesha Lashon Sullivan, BSN, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

95246284 Issued in CA

Practice address

10989 Bluffside Dr Apt 3203
Studio City, CA 91604-4406

Phone

(562) 499-9659

NPI assigned

Oct 24, 2023

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

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Klarity Bridge Telepsych Nursing Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Studio City, CA
  • NPI 1063389856
  NPD Authorized official

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1043082910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10989 BLUFFSIDE DR APT 3203",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916044406",
            "telephone_number": "562-499-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10989 BLUFFSIDE DR APT 3203",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916044406",
            "telephone_number": "562-499-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TYESHA",
        "middle_name": "LASHON",
        "credential": "BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95246284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Studio City Convalescent Hospital LLC
• Studio City Hospice Inc
• Studio City Recovery
• Studio City Surgical Center
• Studio City Urgent Care and Medical Center
• Sally L. Swann, L.C.S.W.
• Violet Szabo
• Dana Mohammed Taha, LCSW 104619
• Sogol Taherinejad
• Anahita Tajbakhsh, D.D.S.

• Adult Psychiatric/Mental Health Registered Nurse in Studio City, CA
• Providers in Studio City, CA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.