MEDICARE: PHOEBE PARK SHINN PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	601300	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	18952	CA
3	363LF0000X	Family Nurse Practitioner	18952	CA

General Provider Information

NPI Number	:	1952464133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHOEBE PARK SHINN PMHNP-BC

Provider Business Mailing Address
First Line	:	2114 ARTESIA BLVD
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3014
Country	:	US
Telephone Number	:	310-392-8636
Fax Number	:	310-943-3521

Provider Business Practice Location Address
First Line	:	13160 MINDANAO WAY STE 213
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-6358
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	04/10/2026

Similar Medicare Providers

1396742813 — DR. TERRY DAVID KREKORIAN M.D.
Practice Location Address:

13160 MINDANAO WAY
MARINA DEL REY, CA
90292-6358

Practice Phone: 310-574-0440
Practice Fax:

1881645026 — EDWARD CARDEN MD INC
Practice Location Address:

13160 MINDANAO WAY , SUITE 300
MARINA DEL REY, CA
90292-6358

Practice Phone: 310-842-8668
Practice Fax: 310-842-8668

1831145937 — DR. SANJAY KUMAR KHURANA M.D.
Practice Location Address:

13160 MINDANAO WAY , SUITE 300
MARINA DEL REY, CA
90292-6358

Practice Phone: 310-854-3800
Practice Fax:

1376655142 — DR. GARY BRAZINA M. D.
Practice Location Address:

13160 MINDANAO WAY , STE 300
MARINA DEL REY, CA
90292-6358

Practice Phone: 310-821-2222
Practice Fax: 310-823-5871

1184736480 — FREDERIC G NICOLA M. D.
Practice Location Address:

13160 MINDANAO WAY , STE 300
MARINA DEL REY, CA
90292-6358

Practice Phone: 310-574-0400
Practice Fax: 310-574-0485

1649362955 — MS. MEGAN ANNE HESSER P.A-C.
Practice Location Address:

13160 MINDANAO WAY , SUITE 300
MARINA DEL REY, CA
90292-6358

Practice Phone: 310-574-0400
Practice Fax:

Directions to “ PHOEBE PARK SHINN PMHNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.