Individual provider Active NPI

Shabnam Rahimi, ARNP

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1467818294
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95005018 Issued in CA
Practice address
1310 E Ocean Blvd #12
Long Beach, CA 90802-1985
Phone
(801) 856-1108
NPI assigned
Jan 9, 2016
Last updated
Nov 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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 9366271 FL
Family Nurse Practitioner 363LF0000X NP95005018 CA Primary

Addresses

Primary practice location

1310 E Ocean Blvd #12
Long Beach, CA 90802-1985

Mailing address

1310 E Ocean Blvd # 12
Long Beach, CA 90802-6900
Phone (801) 856-1108

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
I20240523003404 CA Practitioner - Nurse Practitioner 3072872647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians

Practice addresses (Care Compare)

18191 Von Karman Ave
Suite 100
Irvine, CA 92612-7103
Phone (619) 639-9730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9366271FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. Family CurrentSince Apr 10, 2024 Accepting new patients
Glenn Medical Center, LLC PastSince Apr 10, 2024 Accepting new patients

Locations

18191 Von Karman Ave
Ste 100
Irvine, CA 92612
Phone (619) 639-9738

50 California St
Ste 1500
San Francisco, CA 94111
Phone (310) 648-0700

Organizations & group practices 2

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": "1452297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1467818294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 E OCEAN BLVD # 12",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908026900",
            "telephone_number": "801-856-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 E OCEAN BLVD #12",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021985",
            "telephone_number": "801-856-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHIMI",
        "first_name": "SHABNAM",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-09",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9366271",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95005018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.