Individual provider Active NPI

Patricia Kannas

  • Registered Nurse
  • Long Beach, CA
National Provider Identifier
1285763763
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
264863 Issued in CA
Practice address
6060 N Paramount Blvd
Long Beach, CA 90805-3711
Phone
(562) 630-8672
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 264863 CA Primary

Addresses

Primary practice location

6060 N Paramount Blvd
Long Beach, CA 90805-3711

Mailing address

3604 Ash St
Lake Elsinore, CA 92530-1874
Phone (951) 674-3413

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

State licenses

LicenseStateTypeSpecialty
264863CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285763763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 ASH ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925301874",
            "telephone_number": "951-674-3413"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNAS",
        "first_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "264863",
            "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 Jul 8, 2007; 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.