Healthcare Provider Details

I. General information

NPI: 1467398677
Provider Name (Legal Business Name): PATRICIA CARMEN ROTUNNO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 REDONDO AVE STE 500
LONG BEACH CA
90806-2330
US

IV. Provider business mailing address

14346 CULLEN ST
WHITTIER CA
90605-2110
US

V. Phone/Fax

Practice location:
  • Phone: 844-562-1212
  • Fax: 562-981-0304
Mailing address:
  • Phone: 844-562-1212
  • Fax: 562-981-0304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95207145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: