Kamal A Shamayleh

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

15233 Ventura Blvd Ste 500
Sherman Oaks, CA 91403-2231

Phone

(877) 418-2978

Fax

(866) 500-2816

NPI assigned

Feb 24, 2021

Last updated

Nov 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1083208649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FAIRWAY DR STE 101",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411834",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15233 VENTURA BLVD STE 500",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032231",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1820 W Orangewood Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928685056",
            "country_code": "US",
            "telephone_number": "714-696-2862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMAYLEH",
        "first_name": "KAMAL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-24",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jaquelyn R Shannon

• Other Technician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Other Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.