Healthcare Provider Details

I. General information

NPI: 1083548721
Provider Name (Legal Business Name): JINGLE GAMUEDA TORRES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 REDONDO AVE FL 5
LONG BEACH CA
90806-2325
US

IV. Provider business mailing address

1914 ANCHOR WAY
SEAL BEACH CA
90740-5760
US

V. Phone/Fax

Practice location:
  • Phone: 562-304-1740
  • Fax:
Mailing address:
  • Phone: 559-793-8612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95457535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: