Individual provider Active NPI

Shammeer J Dawson

  • Clinical Social Worker
  • Gardena, CA
National Provider Identifier
1356831689
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
129004 Issued in CA
Practice address
879 W 190TH St Ste 300
Gardena, CA 90248-4223
Phone
(310) 323-6887
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 121068 CA
Clinical Social Worker 1041C0700X 129004 CA Primary

Addresses

Primary practice location

879 W 190TH St Ste 300
Gardena, CA 90248-4223

Mailing address

879 W 190TH St Ste 300
Gardena, CA 90248-4223
Phone (310) 323-6887

Other practice location 1

4401 Crenshaw Blvd
Los Angeles, CA 90043-1227
Phone (323) 290-8360

Other practice location 2

4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 802-0301

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422001142 CA Practitioner - Clinical Social Worker 6507381670 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129004CAMDClinical Social Worker
121068CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Mar 7, 2025 Accepting new patients
Forward Wellness Family Therapy, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Wellnest Emotional Health & Wellness CurrentSince Mar 1, 2021 Accepting new patients
Special Service for Groups, Inc. PastSince May 7, 2024 Accepting new patients

Locations

4401 Crenshaw Blvd
Los Angeles, CA 90043
Phone (323) 290-8360

3031 S Vermont Ave
Los Angeles, CA 90007
Phone (323) 766-2345

1041 E Yorba Linda Blvd
Ste 202
Placentia, CA 92870
Phone (714) 579-0717

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1356831689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 W 190TH ST STE 300",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484223",
            "telephone_number": "310-323-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "879 W 190TH ST STE 300",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484223",
            "telephone_number": "310-323-6887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Crenshaw Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900431227",
            "country_code": "US",
            "telephone_number": "323-290-8360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4211 Avalon Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900115622",
            "country_code": "US",
            "telephone_number": "323-802-0301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "SHAMMEER",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121068",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "129004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.