Active NPI
Lynetta Arnise Shonibare, PSY.D.
- Clinical Psychologist
- Arcadia, CA
National Provider Identifier
1235440306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY25486
- Practice address
- 800 S Santa Anita Ave
Arcadia, CA 91006-3536 - Phone
- (626) 254-5000
- NPI assigned
- Jun 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY25486 | CA | Primary |
Addresses
Primary practice location
800 S Santa Anita Ave
Arcadia, CA 91006-3536
Mailing address
550 S Vermont Ave
Los Angeles, CA 90020-1912
Phone (213) 251-6731
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25486 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1235440306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 S VERMONT AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "213-251-6731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S SANTA ANITA AVE",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910063536",
"telephone_number": "626-254-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHONIBARE",
"first_name": "LYNETTA",
"middle_name": "ARNISE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-23",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY25486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.