Claudette Marie Banda, CNM
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Manhattan Beach, CA
NPI 1306185848 · NPPES record last updated Aug 7, 2023
Key facts
- NPI
- 1306185848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- NP95024761 (CA)
- Practice address
- 1590 Rosecrans Ave Ste D617
Manhattan Beach, CA 90266-3727 - Phone
- (310) 360-7200
- Fax
- (424) 237-3204
- NPI assigned
- Feb 4, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Thomas Health Services Inc
Practice addresses (Care Compare)
1500 Rosecrans Ave
Suite 500
Manhattan Beach, CA 90266-3771
Phone (310) 360-7200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230817003854 | CA | Practitioner - Nurse Practitioner | 5890939839 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001531 | NY | MD | Marriage & Family Therapist |
| NP95024761 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
| 235670 | CA | MD | Advanced Practice Midwife |
| 156602 | TX | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Health Services Inc | Current |
Accepting new patients | |
| Stephens Medical Corporation | Current |
Accepting new patients |
Locations
320 Pine Ave
Ste 1030
Long Beach, CA 90802
Phone (310) 360-7200
11400 W Olympic Blvd
Ste 200
Los Angeles, CA 90064
Phone (401) 359-0757
1590 Rosecrans Ave
Ste D617
Manhattan Beach, CA 90266
Phone (310) 360-7200
1500 Rosecrans Ave
Ste 500
Manhattan Beach, CA 90266
Phone (310) 571-5936
1590 Rosecrans Ave
Ste D
Manhattan Beach, CA 90266
Phone (310) 320-0201
402 W Broadway
Fl 4
San Diego, CA 92101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 235670 | CA | |
| Advanced Practice Midwife | 367A00000X | 001531 | NY | |
| Advanced Practice Midwife | 367A00000X | 156602 | TX | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NP95024761 | CA | Yes |
Addresses
Primary practice location
1590 Rosecrans Ave Ste D617
Manhattan Beach, CA 90266-3727
Mailing address
1590 Rosecrans Ave Ste D617
Manhattan Beach, CA 90266-3727
Phone (310) 360-7200
Other providers in Manhattan Beach, CA
- Azita Tabassian Chiropractic Inc.
- Jennifer Lee Baars
- Raymond Badillo
- Cindy Edwards Baker
- Maryam Bakhtiyari
- Barbara Barry, a Marriage and Family Therapy Professional Corporation
- Barbara L. Schulz,MD, Inc
- Sahar Bardi
- Scott Barlow
- Gabriel Barnard
All providers in Manhattan Beach, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.