Stephanie Shevanne Larsen

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95035782 Issued in CA

Practice address

1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013

Phone

(310) 361-8043

Fax

(310) 986-8241

NPI assigned

May 7, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nueva Vida Psychiatry, a Professional Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
  • NPI 1568318582
  Medicare reassignment NPD Authorized official
• Century City Psychiatry

  • Psychiatry Physician
  • Los Angeles, CA
  • NPI 1508658022
  Medicare reassignment NPD

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1770373383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013",
            "telephone_number": "310-361-8043",
            "fax_number": "310-986-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013",
            "telephone_number": "310-361-8043",
            "fax_number": "310-986-8241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6330 San Vicente Blvd Ste 510",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900485455",
            "country_code": "US",
            "telephone_number": "310-361-8043",
            "fax_number": "310-986-8241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "STEPHANIE",
        "middle_name": "SHEVANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95035782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larsen & Williams Behavioral Consultants Inc
• Donald W. Larsen, M.D.
• Elena Larsen
• Linda Hovanessian Larsen, M.D.
• Robert Larsen
• Todd Larsen, M.D.
• Tyler Larsen
• Larson Health Providers
• Emily Rebecca Larson-McQuaid, PA-C
• Brent K. Larson, D.O.

• Psychiatric/Mental Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, 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 Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.