Healthcare Provider Details

I. General information

NPI: 1760880264
Provider Name (Legal Business Name): ANNABEL TABIANAN HALL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2014
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E. MORNINGSIDE ST.
LONG BEACH CA
90805-6433
US

IV. Provider business mailing address

101 E. MORNINGSIDE ST.
LONG BEACH CA
90805-6433
US

V. Phone/Fax

Practice location:
  • Phone: 800-301-6198
  • Fax:
Mailing address:
  • Phone: 800-301-6198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number547103
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015013
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95015013
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number547103
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License Number547103
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number547103
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number547103
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number547103
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number547103
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number547103
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number547103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: