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General NPI Number Information
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NPI Number | 1922970888
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Entity Type | Individual
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Provider Name | PETRA MARIA SIERRA PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2025
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Last Update Date | 09/20/2025
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Provider Practice Location Address
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Address Line | 3620 LONG BEACH BLVD STE C7
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City | LONG BEACH
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State | CA
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Zip | 90807-6013
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Country | US
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Telephone | 213-290-4585
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Fax |
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Provider Business Mailing Address
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Address Line | 21413 DARTMOOR AVE
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City | LAKEWOOD
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State | CA
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Zip | 90715-2337
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Country | US
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Telephone | 562-708-2012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95034998
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License Number State | CA
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