Shanna L Freeman, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

20639 Issued in CA

Practice address

200 UCLA Medical PLZ Ste 526
Los Angeles, CA 90095-8344

Phone

(310) 267-0182

Fax

(310) 825-4813

NPI assigned

Aug 18, 2009

Last updated

Dec 20, 2019By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: sfreeman587915@direct.uclahealth.org

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1326270877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ STE 526",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-267-0182",
            "fax_number": "310-825-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "SHANNA",
        "middle_name": "L",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "20639",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "792044",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1326270877",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Freeman, PPS SP, PPS SCG
• Marlena C. Freeman
• Mishanda Y Freeman, LCSW
• Nicolle Marie Freeman
• Roberta Freeman, CNS
• Stephanny Freeman, PHD
• Tawney Freeman, PA
• Tiffany R Freeman
• Valerie D Freeman, PA
• Virginia Therese Rich Freeman, AUD

• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.