Individual provider Active NPI

Shannon Younessi, MD

  • Dermatology Physician
  • Sherman Oaks, CA
National Provider Identifier
1790426849
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A207183 Issued in CA
Practice address
4836 Van Nuys Blvd
Sherman Oaks, CA 91403-2101
Phone
(818) 907-7546
Fax
(818) 907-9506
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X A207183 CA Primary

Addresses

Primary practice location

4836 Van Nuys Blvd
Sherman Oaks, CA 91403-2101

Mailing address

4037 San Remo Way
Tarzana, CA 91356-5701
Phone (818) 907-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1790426849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 SAN REMO WAY",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913565701",
            "telephone_number": "818-907-7546",
            "fax_number": "818-907-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4836 VAN NUYS BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032101",
            "telephone_number": "818-907-7546",
            "fax_number": "818-907-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNESSI",
        "first_name": "SHANNON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A207183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.