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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SHALESSE GARDNER PMHNP-BC
NPI 1750045712
Nurse Practitioner - Psychiatric/Mental Health in El Segundo, CA

Active since October 26, 2021PECOS Enrolled
390 N PACIFIC COAST HWY STE 2060, EL SEGUNDO, CA 90245(855) 501-1004 Get Directions Write a Review

NPPES record last updated: October 2, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Oct 2, 2026, Aug 8, 2024 (2 updates tracked since 2024).

About Shalesse Gardner Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHALESSE GARDNER PMHNP-BC (NPI 1750045712) is an individual psychiatric/mental health provider in El Segundo, California, licensed in California (95015664) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Beverly Hills.

NPPES Registry Identity

NPI1750045712
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSHALESSE GARDNERCredential: PMHNP-BC
Location Address390 N PACIFIC COAST HWY STE 2060El Segundo, CA 90245-4401
Mailing Address3835 N Freeway Blvd Ste 100Sacramento, CA 95834-1954
Phone(855) 501-1004
Sole ProprietorYes
Enumeration DateOctober 26, 2021
Last NPPES UpdateOctober 2, 20262 updates tracked since enumeration
NPPES CertifiedOctober 2, 2026
✔ NPI 1750045712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95015664
390 N PACIFIC COAST HWY STE 2060, El Segundo, CA 90245
Open in Google Maps ↗

Secondary Practice Location 1

Location 18383 Wilshire Blvd Ste 202Beverly Hills, CA 90211-2432 · Phone (855) 501-1004 · Fax (310) 432-7065

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shalesse Gardner Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90245 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN PUYAU PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
390 N PACIFIC COAST HWY STE 2060
EL SEGUNDO, CA 90245
Los Angeles County (855) 427-2778
JULIANA HOFT
Social Worker (Clinical)
390 N PACIFIC COAST HWY STE 2060
EL SEGUNDO, CA 90245
Los Angeles County (855) 501-1004
MS. GABRIELLE WANCHEK MA
Marriage & Family Therapist
390 N PACIFIC COAST HWY STE 2060
EL SEGUNDO, CA 90245
Los Angeles County (855) 501-1004
DR. AYOOSH KAKKAR MD
Psychiatry & Neurology (Psychiatry)
390 N PACIFIC COAST HWY STE 2060
EL SEGUNDO, CA 90245
Los Angeles County (855) 501-1004
CHRISTIANNE ZAH-WEBER DNP, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
390 N PACIFIC COAST HWY STE 2060
EL SEGUNDO, CA 90245
Los Angeles County (855) 501-1004
VICKY HO DO
Psychiatry & Neurology (Psychiatry)
390 N PACIFIC COAST HWY STE 2060
EL SEGUNDO, CA 90245
Los Angeles County (855) 501-1004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shalesse Gardner's NPI number?

The NPI number for Shalesse Gardner is 1750045712. It was assigned to this individual provider in the NPPES registry on October 26, 2021.

Where is Shalesse Gardner located?

Shalesse Gardner practices at 390 N Pacific Coast Hwy Ste 2060, El Segundo, CA 90245. The listed phone number is (855) 501-1004.

What is Shalesse Gardner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Shalesse Gardner enrolled in Medicare?

Yes. Shalesse Gardner is registered in the Medicare PECOS enrollment system.

What insurance does Shalesse Gardner accept?

Health plans from Providence Health Plan list Shalesse Gardner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shalesse Gardner was last updated on October 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.