Healthcare Provider Details

I. General information

NPI: 1215497532
Provider Name (Legal Business Name): ADRIAN SHAWNTE WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23824 HAWTHORNE BLVD STE 200
TORRANCE CA
90505-5935
US

IV. Provider business mailing address

2702 COLLEGE PARK DR
LANCASTER CA
93536-5300
US

V. Phone/Fax

Practice location:
  • Phone: 310-791-3064
  • Fax: 310-791-3084
Mailing address:
  • Phone: 661-429-5839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: