Healthcare Provider Details

I. General information

NPI: 1942153952
Provider Name (Legal Business Name): ELEANOR ROSAPAPAN RIDDLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 CHESTNUT AVE
LONG BEACH CA
90813-2945
US

IV. Provider business mailing address

13227 ISIS AVE
HAWTHORNE CA
90250-4935
US

V. Phone/Fax

Practice location:
  • Phone: 562-599-1565
  • Fax:
Mailing address:
  • Phone: 323-893-0989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038047
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: