Madeleine Shore

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10986 Issued in CA

Practice address

11845 W Olympic Blvd Ste 1050W
Los Angeles, CA 90064-5046

Phone

(424) 330-2217

NPI assigned

Jan 21, 2022

Last updated

Feb 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Behavioral Care of California, P.C.

  • Counseling Psychologist
  • Malibu, CA
  • NPI 1205698479
  NPD (past)

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1447902317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7046 CREBS AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354024",
            "telephone_number": "615-415-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11845 W OLYMPIC BLVD STE 1050W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645046",
            "telephone_number": "424-330-2217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24903 Pacific Coast Hwy Ste 102",
            "address_purpose": "LOCATION",
            "city": "Malibu",
            "state": "CA",
            "postal_code": "902654734",
            "country_code": "US",
            "telephone_number": "310-310-9249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORE",
        "first_name": "MADELEINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "10986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Lee Shook, M.D.
• Keith Patrick Shopa, MD
• Shore MDS Medical Corp
• Cody Shore
• Ma. Teresita Borio Shore, PTA
• Alison Short
• Kilene Short
• Rein Short, L.AC.
• Barris Shorte
• Jocelyn Shorts, MD, MPH, MSC

• Professional Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.