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General NPI Number Information
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NPI Number | 1912576687
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Entity Type | Individual
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Provider Name | ANDREA SHINO KASEGUMA FNP
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Gender | Female
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8767 WILSHIRE BLVD FL 3
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2714
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Country | US
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Telephone | 310-423-2718
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Fax | 310-314-8735
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Provider Business Mailing Address
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Address Line | 4140 W 190TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-5513
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Country | US
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Telephone | 310-423-2718
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Fax | 310-314-8735
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2328897
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95015942
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License Number State | CA
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