Individual provider · NPI-1

Shaunte E Anderson, FNP

Nurse Practitioner, Family · Gardena, CA

NPI number1639717218

StatusActive

Last updated in NPPESSep 18, 2025

Details

NPI: 1639717218
Entity type: Individual (NPI-1)
Name: Shaunte E Anderson
Credential: FNP
Sex: Female
Sole proprietor: Yes
Enumeration date: Dec 14, 2019
Certification date: Sep 18, 2025
Last updated: Sep 18, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	95012291	CA	Yes
207Q00000X	Family Medicine	95012991	CA

Practice location

1025 W 190th St Ste 450
Gardena, CA 90248-4339

Phone 310-782-1177

Mailing address

13089 Peyton Dr
Chino Hills, CA 91709-6018

Phone 562-682-5091

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.