Individual provider Active NPI

Sheku Fofana, FNP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1730848029
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95019700 Issued in CA
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, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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 Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
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

  • Direct secure messaging: 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.

Verify at the official NPI Registry.