1669401824 NPI number — DR. JEANNE ABAYA TAPIA DNP, FNP

Table of content: DR. JEANNE ABAYA TAPIA DNP, FNP (NPI 1669401824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669401824 NPI number — DR. JEANNE ABAYA TAPIA DNP, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAPIA
Provider First Name:
JEANNE
Provider Middle Name:
ABAYA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABAYA
Provider Other First Name:
JEANNE
Provider Other Middle Name:
FERMINA NICOLAS
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DNP, FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669401824
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 661360
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARCADIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91066-1360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-447-0296
Provider Business Mailing Address Fax Number:
626-447-6057

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1050 LINDEN AVE
Provider Second Line Business Practice Location Address:
EMPLOYEE HEALTH CLINIC
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90813-3321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-491-9095
Provider Business Practice Location Address Fax Number:
562-491-9896
Provider Enumeration Date:
07/01/2006

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: 363L00000X , with the licence number:  NP13932 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: RN611739 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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