Healthcare Provider Details

I. General information

NPI: 1073743050
Provider Name (Legal Business Name): VERONICA MIRANDA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 HUGHES WAY
LONG BEACH CA
90810-1864
US

IV. Provider business mailing address

1500 HUGHES WAY
LONG BEACH CA
90810-1864
US

V. Phone/Fax

Practice location:
  • Phone: 213-503-0650
  • Fax:
Mailing address:
  • Phone: 213-503-0650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY27824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: