Healthcare Provider Details

I. General information

NPI: 1154577732
Provider Name (Legal Business Name): CHARLYNE GABRIEL-JACQUES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHARLYNE GABRIEL-JACQUES ARNP

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OCEANGATE STE 100
LONG BEACH CA
90802-4317
US

IV. Provider business mailing address

200 OCEANGATE STE 100
LONG BEACH CA
90802-4317
US

V. Phone/Fax

Practice location:
  • Phone: 305-382-4161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9213937
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14213618-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP9213937
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9213937
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: