Individual provider Active NPI

Lea Pauline Sherman, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1235771932
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95025042 Issued in CA
Practice address
2810 Camino del Rio S Ste 102
San Diego, CA 92108-3819
Phone
(619) 299-1419
Fax
(858) 461-6008
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95025042 CA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61005993 WA

Addresses

Primary practice location

2810 Camino del Rio S Ste 102
San Diego, CA 92108-3819

Mailing address

2810 Camino del Rio S Ste 102
San Diego, CA 92108-3819
Phone (619) 299-1419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210105003016 WA Practitioner - Nurse Practitioner 9436562733 Reassigns benefits to 1 organization
I20230831003649 CA Practitioner - Nurse Practitioner 9436562733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Systems IncGroup PAC ID 8628019320, 37 clinicians

Practice addresses (Care Compare)

474 W Vermont Ave
Suite 101
Escondido, CA 92025-6584
Phone (760) 480-2255

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems, Inc. Current Accepting new patients
Sound CurrentSince Oct 1, 2020 Accepting new patients
Mental Health Systems, Inc. CurrentSince Jul 9, 2023 Accepting new patients

Locations

474 W Vermont Ave
Ste 101
Escondido, CA 92025
Phone (760) 480-2255

9465 Farnham St
San Diego, CA 92123
Phone (858) 576-4311

4238 Auburn Way N
Auburn, WA 98002
Phone (253) 444-0106

4240 Auburn Way N
Auburn, WA 98002
Phone (253) 876-8900

1600 E Olive St
Seattle, WA 98122
Phone (206) 302-2800

6400 Southcenter Blvd
Tukwila, WA 98188
Phone (206) 444-3600

Organizations & group practices 3

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": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1235771932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083819",
            "telephone_number": "619-299-1419",
            "fax_number": "858-461-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083819",
            "telephone_number": "619-299-1419",
            "fax_number": "858-461-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "LEA",
        "middle_name": "PAULINE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025042",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61005993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.