Individual provider Active NPI

Kamsey Shawna Cubarrubias

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1639858764
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
291080 Issued in AZ
Practice address
200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone
(480) 952-4658
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 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 1571253 ID
Family Nurse Practitioner 363LF0000X 291080 AZ Primary

Addresses

Primary practice location

200 Oceangate Ste 100
Long Beach, CA 90802-4317

Mailing address

200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone (480) 952-4658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA, MI, ID4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20230822000686 AZ Practitioner - Nurse Practitioner 7719349869 Reassigns benefits to 1 organization
I20231030002284 WA Practitioner - Nurse Practitioner 7719349869 Reassigns benefits to 1 organization
I20250306003566 MI Practitioner - Nurse Practitioner 7719349869 Reassigns benefits to 1 organization
I20250508002918 ID Practitioner - Nurse Practitioner 7719349869 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1571253IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of Washington, Inc Current Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince Oct 17, 2023 Accepting new patients
Molina Care Connections, LLC. CurrentSince Aug 21, 2023 Accepting new patients

Locations

5055 E Washington St
Ste 210
Phoenix, AZ 85034
Phone (800) 424-5891

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

880 W Long Lake Rd
Troy, MI 48098
Phone (248) 227-6316

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

Interoperability endpoints

  • Direct secure messaging: kcubarrubias15049@direct-prd.molinahealthcare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1639858764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "480-952-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "480-952-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUBARRUBIAS",
        "first_name": "KAMSEY",
        "middle_name": "SHAWNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "1571253",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "291080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.