Samantha McKinnon, APRN, NP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95023202 Issued in CA

Practice address

18411 Crenshaw Blvd Ste 360
Torrance, CA 90504-5060

Phone

(213) 340-2613

NPI assigned

Jun 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 15

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Neuro Wellness Spa, a Medical PC

  • Psychiatry Physician
  • Manhattan Beach, CA
  • NPI 1003394149
  NPD (past)
• Thuy T M Nguyen M D Inc

  • Urgent Care Clinic/Center
  • Montclair, CA
  • NPI 1558503169
  NPD (past)
• Texienne Oncology Centers, PLLC

  • Hematology & Oncology Physician
  • The Woodlands, TX
  • NPI 1700017449
  NPD (past)

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1609436922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 CRENSHAW BLVD STE 360",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18411 CRENSHAW BLVD STE 360",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045060",
            "telephone_number": "213-340-2613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2330 S LaMar Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787045265",
            "country_code": "US",
            "telephone_number": "888-828-5881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5131 Nellie Ct",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917395132",
            "country_code": "US",
            "telephone_number": "909-297-3361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "SAMANTHA",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "12707814-3102",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1686036",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "T20230052",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95308835",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352966",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95023202",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11019305",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0003288-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC003943",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142077",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61224221",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "12707814-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A165389",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023202",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "877963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassidy Ann McKenzie
• Frances A McKindsey, M.D.
• James Alexander McKinnell, M.D.
• Kelly Marie McKinney
• Madison McKinnon
• John K McKissock, MD
• Tanisha Lorie McLean, PMHNP
• Emma Mae McLeod
• James McLindon, LMFT
• Chudney Dorise McLyn

• Psychiatric/Mental Health Nurse Practitioner in Torrance, CA
• Providers in Torrance, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.