Shana Matatov, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95025038 Issued in CA

Practice address

4919 Laurel Canyon Blvd Apt 16
Valley Village, CA 91607-3734

Phone

(310) 467-0873

NPI assigned

Aug 21, 2023

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1922882067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 LAUREL CANYON BLVD APT 16",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073734",
            "telephone_number": "310-467-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4919 LAUREL CANYON BLVD APT 16",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073734",
            "telephone_number": "310-467-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATATOV",
        "first_name": "SHANA",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Marks
• Megan Elyse Marks
• Silvina L Martin, LMFT
• Noemi Martinez-Bary
• Gerald Eizan Mason, L. AC.
• Matsix, LLC
• Matteo R Muti,Jr
• Maurice S. Haber, M.D. a Medical Corporation (A Medical Corporation)
• Maviana Home Health
• Mavianna Home Health

• Family Nurse Practitioner in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.