Active NPI
Vivian Shen
- Neurology Physician
- Los Angeles, CA
National Provider Identifier
1336775295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- A185982
- Practice address
- 300 Medical Plaza Suite B200
Los Angeles, CA 90095-7419 - Phone
- (310) 794-1195
- NPI assigned
- Mar 22, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurology Physician | 2084N0400X | A185982 | CA | Primary |
Addresses
Primary practice location
300 Medical Plaza Suite B200
Los Angeles, CA 90095-7419
Mailing address
710 Westwood PLZ # Reeda246
Los Angeles, CA 90095-7419
Phone (310) 794-1195
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220331002919 | CA | Order and Referring Only - Neurology | 7517353402 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1336775295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 WESTWOOD PLZ # REEDA246",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900957419",
"telephone_number": "310-794-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MEDICAL PLAZA SUITE B200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900957419",
"telephone_number": "310-794-1195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEN",
"first_name": "VIVIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-22",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "A185982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.