Individual provider Active NPI

Shaina Fawn, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1073028502
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
68022 Issued in CA
Practice address
6000 N Figueroa St
Los Angeles, CA 90042-4232
Phone
(323) 254-5291
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 68022 CA Primary

Addresses

Primary practice location

6000 N Figueroa St
Los Angeles, CA 90042-4232

Mailing address

4470 W Sunset Blvd Ste 178
Los Angeles, CA 90027-6051
Phone (720) 275-3491

Other practice location 1

4837 Huntington Dr N
Los Angeles, CA 90032-1981
Phone (323) 254-5291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180423002885 CA Practitioner - Clinical Social Worker 8527321637 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68022CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Counseling CurrentSince Apr 1, 2025 Accepting new patients
Elica Health Centers CurrentSince Feb 18, 2025 Accepting new patients
Elica Health Centers CurrentSince Feb 18, 2025 Accepting new patients
Elica Health Centers Current Accepting new patients

Locations

11835 W Olympic Blvd
Ste 815E
Los Angeles, CA 90064
Phone (323) 332-9905

4815 Watt Ave
North Highlands, CA 95660

1860 Howe Ave
Ste 440
Sacramento, CA 95825

1750 Wright St
Ste 1
Sacramento, CA 95825

155 15th St
Ste A
West Sacramento, CA 95691
Phone (916) 375-8981

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1073028502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 W SUNSET BLVD STE 178",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276051",
            "telephone_number": "720-275-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424232",
            "telephone_number": "323-254-5291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4837 Huntington Dr N",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900321981",
            "country_code": "US",
            "telephone_number": "323-254-5291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWN",
        "first_name": "SHAINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "68022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.