Healthcare Provider Details

I. General information

NPI: 1851588875
Provider Name (Legal Business Name): FAITH TUBI REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAITH TUBI. FAITH TUBI

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 11/20/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA LONG BEACH HEALTHCARE SYSTEM 5901 EAST 7TH STREET, L216
LONG BEACH CA
90822
US

IV. Provider business mailing address

VA LONG BEACH HEALTHCARE SYSTEM 5901 EAST 7TH STREET, L216
LONG BEACH CA
90822
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax: 562-346-3601
Mailing address:
  • Phone: 562-826-8000
  • Fax: 562-346-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95206021
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2024057417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: