Provider Demographics
NPI:1669548780
Name:GABERTAN TENAZAS, SHARON MAE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MAE
Last Name:GABERTAN TENAZAS
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:1045 ATLANTIC AVE
Mailing Address - Street 2:SUITE 715
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3408
Mailing Address - Country:US
Mailing Address - Phone:562-983-5408
Mailing Address - Fax:562-432-1864
Practice Address - Street 1:1045 ATLANTIC AVE
Practice Address - Street 2:SUITE 715
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3408
Practice Address - Country:US
Practice Address - Phone:562-983-5408
Practice Address - Fax:562-432-1864
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2014-07-24
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Provider Licenses
StateLicense IDTaxonomies
CARN436900363LP0200X
CA436900363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics