Individual provider Active NPI

Shamara Monique Long, RN

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Altadena, CA
National Provider Identifier
1407031453
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
95395942 Issued in CA
Practice address
760 W. Mountain View St.
Alta Dena, CA 91001
Phone
(626) 798-6793
NPI assigned
Jan 8, 2008
Last updated
Jul 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95395942 CA
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 95395942 CA Primary
Licensed Vocational Nurse 164X00000X VN 230989 CA

Addresses

Primary practice location

760 W. Mountain View St.
Alta Dena, CA 91001

Mailing address

760 W. Mountain View St.
Alta Dena, CA 91001
Phone (517) 879-3209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95395942CAMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
VN 230989CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1407031453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 W. MOUNTAIN VIEW ST.",
            "city": "ALTA DENA",
            "state": "CA",
            "postal_code": "91001",
            "telephone_number": "517-879-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 W. MOUNTAIN VIEW ST.",
            "city": "ALTA DENA",
            "state": "CA",
            "postal_code": "91001",
            "telephone_number": "626-798-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "SHAMARA",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95395942",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "95395942",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN 230989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.