Provider Demographics
NPI:1952191421
Name:LANDEROS, ADAM JOSEPH (MPH MS)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:JOSEPH
Last Name:LANDEROS
Suffix:
Gender:
Credentials:MPH MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 W OCEAN BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4529
Mailing Address - Country:US
Mailing Address - Phone:562-366-9027
Mailing Address - Fax:
Practice Address - Street 1:1567 N VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-1940
Practice Address - Country:US
Practice Address - Phone:323-573-9879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker