Active NPI
Sheku Fofana, FNP
- Family Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1730848029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95019700
- Practice address
- 10780 Santa Monica Blvd Ste 105
Los Angeles, CA 90025-7613 - Phone
- (424) 521-1066
- Fax
- (424) 326-8553
- NPI assigned
- Dec 14, 2021
- Last updated
- Nov 13, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95019700 | CA | Primary |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95019700 | CA | |
| Critical Care Medicine Registered Nurse | 163WC0200X | 95098561 | CA |
Addresses
Primary practice location
10780 Santa Monica Blvd Ste 105
Los Angeles, CA 90025-7613
Mailing address
4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 248-7000
Other practice location 1
112 N Avenue 66 Apt 5
Los Angeles, CA 90042-2974
Phone (949) 813-3442
Other practice location 2
8767 Wilshire Blvd Fl 2
Beverly Hills, CA 90211-2714
Phone (310) 248-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 89.14 of 100
- Quality
- 84.79
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 73.15
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- sfofana200752@direct.cshs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1730848029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 W 190TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905045513",
"telephone_number": "310-248-7000",
"fax_number": "310-248-7033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10780 SANTA MONICA BLVD STE 105",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900257613",
"telephone_number": "424-521-1066",
"fax_number": "424-326-8553"
}
],
"practiceLocations": [
{
"address_1": "112 N Avenue 66 Apt 5",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900422974",
"country_code": "US",
"telephone_number": "949-813-3442",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8767 Wilshire Blvd Fl 2",
"address_purpose": "LOCATION",
"city": "Beverly Hills",
"state": "CA",
"postal_code": "902112714",
"country_code": "US",
"telephone_number": "310-248-7000",
"fax_number": "310-248-7033",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOFANA",
"first_name": "SHEKU",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-14",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95019700",
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95019700",
"primary": false
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "CA",
"license": "95098561",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.