Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 22966 | CA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN22966 | CA |
NPI | 1003255779 |
---|---|
Provider Name | Ms. Eunice N Bisong |
First Address | Long Beach, CA 90810-1878 |
Second Address | Long Beach, CA 90810-1878 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 18/01/2022 |