Shared Harvest Foundation Inc

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

SHARED HARVEST FOUNDATION INC

Practice address

10000 Washington Blvd Ste 600
Culver City, CA 90232-2783

Phone

(323) 880-0121

Fax

(801) 665-5652

NPI assigned

Apr 14, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Nanaefua Afoh-Manin, MD

Title

Chief Medical Officer

Phone

(917) 748-3832

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SHARED HARVEST MYCOVIDMD Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659571200000",
    "number": "1932789757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23934 DECORAH RD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651407",
            "telephone_number": "917-748-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 WASHINGTON BLVD STE 600",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322783",
            "telephone_number": "323-880-0121",
            "fax_number": "801-665-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARED HARVEST FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A",
        "authorized_official_last_name": "AFOH-MANIN",
        "authorized_official_first_name": "NANAEFUA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "917-748-3832",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B4082017",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "covidmd@sharedharvestfund.org",
            "affiliation": "N",
            "endpointDescription": "provider address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10000 Washington Blvd Ste 600",
            "city": "Culver City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902322783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SHARED HARVEST MYCOVIDMD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SHARED HARVEST MYCOVIDMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Safia Naveed Shams
• Seena C Shanks
• Arlene Shapiro
• Cydne Jenae Shapiro, OTR/L
• Share
• Michelle Divya Sharma
• Nafisa Sharmin
• Sharona Yashar, MD Inc
• Ashley Charise Shattles
• Tracy Denise Shaw, PH.D.

• Community Health Clinic/Center in Culver City, CA
• Providers in Culver City, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.