Individual provider Active NPI

Shanna Whitlow

  • Marriage & Family Therapist
  • Culver City, CA
National Provider Identifier
1952749996
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone
(310) 390-6612
Fax
(310) 398-5690
NPI assigned
Jun 12, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CA
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

4760 Sepulveda Blvd
Culver City, CA 90230-4820

Mailing address

1007 Myrtle Ave
Inglewood, CA 90301-4009
Phone (310) 412-4191

Other practice location 1

4211 S. Avalon Blvd.
Los Angeles, CA 90011
Phone (818) 996-1051

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250906000100 CA Practitioner - Marriage and Family Therapist 7719489970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4760 Sepulveda Blvd
Culver City, CA 90230-4820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Didi Hirsch Psychiatric Service CurrentSince Jun 23, 2025 Accepting new patients
Didi Hirsch Psychiatric Service Current Accepting new patients
Didi Hirsch Psychiatric Service CurrentSince Jun 23, 2025 Accepting new patients

Locations

1007 Myrtle Ave
Inglewood, CA 90301
Phone (310) 412-4191

4760 Sepulveda Blvd
Los Angeles, CA 90230
Phone (310) 751-5344

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952749996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MYRTLE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014009",
            "telephone_number": "310-412-4191",
            "fax_number": "310-751-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612",
            "fax_number": "310-398-5690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 S. Avalon Blvd.",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90011",
            "country_code": "US",
            "telephone_number": "818-996-1051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLOW",
        "first_name": "SHANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2022-07-21",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.