Individual provider Active NPI

Shivalee Mansukh Dadhania

  • Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1215525480
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95018005 Issued in CA
Practice address
200 W Santa Ana Blvd Ste 1000
Santa Ana, CA 92701-7552
Phone
(714) 480-6767
NPI assigned
Jan 4, 2021
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95018005 CA Primary

Addresses

Primary practice location

200 W Santa Ana Blvd Ste 1000
Santa Ana, CA 92701-7552

Mailing address

200 W Santa Ana Blvd Ste 1000
Santa Ana, CA 92701-7552
Phone (714) 480-6767

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220201001059 CA Practitioner - Nurse Practitioner 5294128971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OrangeGroup PAC ID 1951215789, 45 clinicians

Practice addresses (Care Compare)

401 W Civic Ctr Dr
Suite 801
Santa Ana, CA 92701-4515
Phone (714) 480-6767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
County of Orange CurrentSince Feb 16, 2025 Accepting new patients
County of Orange CurrentSince Sep 1, 2024 Accepting new patients
County of Orange CurrentSince Feb 16, 2025 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jun 27, 2022 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jun 27, 2022 Accepting new patients

Locations

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

1529 E Palmdale Blvd
Ste 150
Palmdale, CA 93550
Phone (661) 575-1800

2260 E Palmdale Blvd
Ste J
Palmdale, CA 93550
Phone (661) 575-1800

200 W Santa Ana Blvd
Ste 1000
Santa Ana, CA 92701
Phone (714) 480-6641

401 W Civic Center Dr
Ste 801
Santa Ana, CA 92701

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1215525480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W SANTA ANA BLVD STE 1000",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927017552",
            "telephone_number": "714-480-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W SANTA ANA BLVD STE 1000",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927017552",
            "telephone_number": "714-480-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADHANIA",
        "first_name": "SHIVALEE",
        "middle_name": "MANSUKH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95018005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.