Individual provider Active NPI

Shaunte E Anderson, FNP

  • Family Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1639717218
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95012291 Issued in CA
Practice address
1025 W 190TH St Ste 450
Gardena, CA 90248-4339
Phone
(310) 782-1177
NPI assigned
Dec 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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 95012291 CA Primary
Family Medicine Physician 207Q00000X 95012991 CA

Addresses

Primary practice location

1025 W 190TH St Ste 450
Gardena, CA 90248-4339

Mailing address

13089 Peyton Dr
Chino Hills, CA 91709-6018
Phone (562) 682-5091

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
I20200504001024 CA Practitioner - Nurse Practitioner 0547691784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1007 Iris St
Redwood City, CA 94061-1503

21622 NE 11TH Place
Sammamish, WA 98074

330 Edmondson St
Summerville, CA 30747-2141

750 The City Dr S
Suite 120
Orange, CA 92868-6945

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95012991CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ella Belle Loving Care LLC Current Accepting new patients
J M Geiss DO Apc Family Medicine CurrentSince Mar 19, 2020 Accepting new patients
Reviva Wound Care Specialists Family Medicine CurrentSince Sep 1, 2025 Accepting new patients
Seasons Medical Group of California Incorporated CurrentSince Jan 3, 2022 Accepting new patients
Global Wound Care Medical Group CurrentSince Sep 9, 2023 Accepting new patients
Concertocare Medical Group of California, P.C. Family Medicine PastSince Mar 1, 2023 Accepting new patients
Seasons Hospice & Palliative Care of California- San Bernardino, LLC Family Medicine Past Accepting new patients
Hospice Care of America, LLC PastSince May 3, 2020 Accepting new patients

Locations

320 Arden Ave
Ste 100
Glendale, CA 91203
Phone (626) 568-5000

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

750 The City Dr S
Ste 120
Orange, CA 92868
Phone (714) 980-0900

701 W Kimberly Ave
Ste 200
Placentia, CA 92870
Phone (657) 444-1233

8686 Haven Ave
Ste 300
Rancho Cucamonga, CA 91730
Phone (909) 981-1136

180 Promenade Cir
Ste 300
Sacramento, CA 95834
Phone (916) 352-6232

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

Interoperability endpoints

  • Direct secure messaging: shaunte.anderson@746395612545028.direct.elationemr.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1576281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1639717218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13089 PEYTON DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096018",
            "telephone_number": "562-682-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W 190TH ST STE 450",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484339",
            "telephone_number": "310-782-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHAUNTE",
        "middle_name": "E",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-14",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012291",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95012991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.