Amanda Shaw, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95019414 Issued in CA

Practice address

18602 Demion LN Apt C
Huntington Beach, CA 92646-8812

Phone

(661) 319-7834

NPI assigned

Mar 14, 2022

Last updated

Mar 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for New Directions IncGroup PAC ID 9335475870, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Center for New Directions, Inc.

  • Mental Health Counselor
  • Laguna Hills, CA
  • NPI 1578121190
  Medicare reassignment Care Compare group NPD
• Sondermind Professional Clinical Counselor, PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1598629362
  Medicare reassignment
• Stephen M Pumphrey Licensed Clinical Social Workers Inc

  • Clinical Social Worker
  • Laguna Hills, CA
  • NPI 1386862969
  NPD (past)

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1083362560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18602 DEMION LN APT C",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926468812",
            "telephone_number": "661-319-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18602 DEMION LN APT C",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926468812",
            "telephone_number": "661-319-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "AMANDA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95019414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Lawrence Shapiro, DMD
• Sharifian and Huston Dental Corporation (Beach Dental Group)
• Victoria Cilluffo Sharma, LCSW
• Aimee Lynn Shaw
• Alan Shaw, DDS, MD
• David G Shaw, DC
• Montgomery Shaw
• Payton Ann Shaw
• Louay Shawesh, MD
• Shawn Crum, D.O., M.P.H. a Medical Corporation

• Psychiatric/Mental Health Nurse Practitioner in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.