Individual provider Active NPI

Shetonya Sinclair

  • Marriage & Family Therapist
  • Redondo Beach, CA
National Provider Identifier
1922237080
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
65177 Issued in CA
Practice address
901 N Pacific Coast Hwy
200A-204a
Redondo Beach, CA 90277-2162
Phone
(702) 574-1857
NPI assigned
Jul 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 65177 CA Primary

Addresses

Primary practice location

901 N Pacific Coast Hwy
200A-204a
Redondo Beach, CA 90277-2162

Mailing address

PO Box 20482
Long Beach, CA 90801-3482
Phone (702) 574-1857

Other names 1

  • Ms. Shetonya Fordham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
65177CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1922237080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20482",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908013482",
            "telephone_number": "702-574-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N PACIFIC COAST HWY",
            "address_2": "200A-204A",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772162",
            "telephone_number": "702-574-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINCLAIR",
        "first_name": "SHETONYA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "65177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHETONYA",
            "last_name": "FORDHAM",
            "prefix": "MS.",
            "credential": "MFT-INTERN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.