Individual provider Active NPI

Phoebe Park Shinn, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Marina del Rey, CA
National Provider Identifier
1952464133
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
18952 Issued in CA
Practice address
13160 Mindanao Way Ste 213
Marina del Rey, CA 90292-6358
Phone
(925) 282-1778
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 601300 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 18952 CA Primary
Family Nurse Practitioner 363LF0000X 18952 CA

Addresses

Primary practice location

13160 Mindanao Way Ste 213
Marina del Rey, CA 90292-6358

Mailing address

2114 Artesia Blvd
Redondo Beach, CA 90278-3014
Phone (310) 392-8636

Other practice location 1

2114 Artesia Blvd
Redondo Beach, CA 90278-3014
Phone (310) 392-8636

Other names 1

  • Phoebe S Park Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address phoebe.shinn.p1@direct.venicefamilyclinic.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140521000331 CA Practitioner - Nurse Practitioner 2365510161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

13160 Mindanao Way
Suite 213
Marina del Rey, CA 90292-6358
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic CurrentSince Mar 4, 2014 Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic CurrentSince Mar 4, 2014 Accepting new patients

Locations

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

2114 Artesia Blvd
Redondo Beach, CA 90278
Phone (310) 318-2521

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630

Interoperability endpoints

  • Direct secure messaging: pshinn792353@direct.ochin.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1952464133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783014",
            "telephone_number": "310-392-8636",
            "fax_number": "310-943-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY STE 213",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926358",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2114 Artesia Blvd",
            "address_purpose": "LOCATION",
            "city": "Redondo Beach",
            "state": "CA",
            "postal_code": "902783014",
            "country_code": "US",
            "telephone_number": "310-392-8636",
            "fax_number": "310-943-3521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHINN",
        "first_name": "PHOEBE",
        "middle_name": "PARK",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "601300",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "18952",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18952",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phoebe.shinn.p1@direct.venicefamilyclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "phoebe.shinn.p1@direct.venicefamilyclinic.nextgenshare.com",
            "address_1": "2114 Artesia Blvd",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902783014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PHOEBE",
            "last_name": "PARK",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.