Individual provider Active NPI

Fines Pafira Shaw, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaumont, CA
National Provider Identifier
1467095224
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95012926 Issued in CA
Practice address
35232 Hogan Dr
Beaumont, CA 92223-7407
Phone
(951) 581-9399
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95012926 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95012926 CA Primary

Addresses

Primary practice location

35232 Hogan Dr
Beaumont, CA 92223-7407

Mailing address

35232 Hogan Dr
Beaumont, CA 92223-7407
Phone (714) 484-4900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221110002804 CA Practitioner - Nurse Practitioner 8426425091 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95012926CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pamoja Advanced Nursing Practice Inc CurrentSince Jul 22, 2022 Accepting new patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Nov 10, 2022 Accepting new patients
Mellow Medical Inc a Professional Corporation CurrentSince Nov 10, 2022 Accepting new patients

Locations

710 N Euclid St
Ste 208
Anaheim, CA 92801
Phone (714) 484-4900

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (888) 284-2779

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

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1467095224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35232 HOGAN DR",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922237407",
            "telephone_number": "714-484-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35232 HOGAN DR",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922237407",
            "telephone_number": "951-581-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "FINES",
        "middle_name": "PAFIRA",
        "credential": "PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012926",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95012926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

Verify at the official NPI Registry.