Individual provider Active NPI

Corrinn Nicole Cunningham-Clevenger, PMHNP

  • Registered Nurse
  • Long Beach, CA
National Provider Identifier
1083475826
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95351534 Issued in CA
Practice address
6060 N Paramount Blvd
Long Beach, CA 90805-3711
Phone
(562) 630-8672
Fax
(562) 529-2463
NPI assigned
Jan 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95040942 CA
Registered Nurse 163W00000X 95351534 CA Primary

Addresses

Primary practice location

6060 N Paramount Blvd
Long Beach, CA 90805-3711

Mailing address

27000 W Lugonia Ave Apt 12318
Redlands, CA 92374-2099
Phone (707) 346-0696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95351534CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1083475826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27000 W LUGONIA AVE APT 12318",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742099",
            "telephone_number": "707-346-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 N PARAMOUNT BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908053711",
            "telephone_number": "562-630-8672",
            "fax_number": "562-529-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM-CLEVENGER",
        "first_name": "CORRINN",
        "middle_name": "NICOLE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95040942",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95351534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.