Healthcare Provider Details

I. General information

NPI: 1336972728
Provider Name (Legal Business Name): SAMANTHA A ARTEAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E 7TH ST
LONG BEACH CA
90804-4590
US

IV. Provider business mailing address

2025 E 7TH ST
LONG BEACH CA
90804-4590
US

V. Phone/Fax

Practice location:
  • Phone: 562-481-6860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: