Chelsea Lee Shannon, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

A195142 Issued in CA

Practice address

760 Westwood PLZ Ste 37-384
Los Angeles, CA 90024-5055

Phone

(310) 206-5674

NPI assigned

Apr 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• San Joaquin Behavioral Health Services

  dba San Joaquin County Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931
  Medicare reassignment NPD
• County of San Joaquin

  dba San Joaquin County Clinic Manteca

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• San Joaquin County Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lodi, CA
  • NPI 1265647234
  NPD

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1891437760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ STE 37-384",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ STE 37-384",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "310-206-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "CHELSEA",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A195142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A195142",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joey Shanley, LCSW
• Shannon K. Carter Psychologist, Inc.
• Shannon Stevens Speech Pathology LLC (Santa Monica Speaks)
• Lori Fontaine Shannon-Amely, NP
• Angela P. Shannon, M.D.
• Dewanna Denise Shannon, MS
• James Benjamin Shannon, THERAPIST
• Kevin Micheal Shannon, M.D.
• Makaila Shannon
• Mary Vivianne Shannon, DDS

• Student in an Organized Health Care Education/Training Program in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.