Provider Demographics
NPI:1366817876
Name:LONG, PATRICIA ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:LONG
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:202 E BORT ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2235
Mailing Address - Country:US
Mailing Address - Phone:562-933-3716
Mailing Address - Fax:568-933-3365
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1701
Practice Address - Country:US
Practice Address - Phone:562-933-3716
Practice Address - Fax:562-933-3365
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA134554363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner