Provider Demographics
NPI:1154663276
Name:PATEL, PATRICIA NIRAV (FNP-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NIRAV
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3747 WORSHAM AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1774
Mailing Address - Country:US
Mailing Address - Phone:562-430-4513
Mailing Address - Fax:562-430-7718
Practice Address - Street 1:3747 WORSHAM AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1774
Practice Address - Country:US
Practice Address - Phone:562-430-4513
Practice Address - Fax:562-430-7718
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP10202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily