1184903791 NPI number — MRS. ANNA LUTY LITTLEFORD MA, CPRP

Table of content: MRS. ANNA LUTY LITTLEFORD MA, CPRP (NPI 1184903791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184903791 NPI number — MRS. ANNA LUTY LITTLEFORD MA, CPRP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LITTLEFORD
Provider First Name:
ANNA
Provider Middle Name:
LUTY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA, CPRP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUTY
Provider Other First Name:
ANNA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184903791
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 W BROADWAY
Provider Second Line Business Mailing Address:
SUITE 5010
Provider Business Mailing Address City Name:
LONG BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90802-4431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-285-1330
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 W BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 5010
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90802-4431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-881-3054
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)