Provider Demographics
NPI:1245968908
Name:FLANNERY, PATRICIA (FNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21052 LAGUNA CANYON RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-1146
Mailing Address - Country:US
Mailing Address - Phone:708-261-1314
Mailing Address - Fax:
Practice Address - Street 1:16300 SAND CANYON AVE STE 711
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3707
Practice Address - Country:US
Practice Address - Phone:949-404-3060
Practice Address - Fax:949-203-6446
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021782363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care