LEGACY ADVANCED NURSING PRACTICE INCORPORATED NPI 1548905391

NPI Information

NPI: 1548905391
Provider Name: LEGACY ADVANCED NURSING PRACTICE INCORPORATED
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
710 N EUCLID ST STE 208
ANAHEIM, CA
ZIP 92801
Phone: (714) 844-5804
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LEGACY ADVANCED NURSING PRACTICE INCORPORATED is a psychiatric/mental health nurse practitioner in Anaheim, CA. LEGACY ADVANCED NURSING PRACTICE INCORPORATED NPI is 1548905391. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

710 N EUCLID ST STE 208
ANAHEIM, CA
ZIP 92801-132
Phone: (714) 844-5804
Fax: (714) 888-7216

The provider's authorized official is Tyisha Renee Fletcher .
The authorized official title is Nurse Practitioner and has the following contact phone number (310) 251-6727.

The enumeration date for this NPI number is 5/4/2022 and was last updated on 12/29/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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