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NPI Code Detail

MEDICARE: KARISSA TANIMINE

MEDICARE: KARISSA TANIMINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSP13732CA

General Provider Information

NPI Number : 1780390153
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARISSA TANIMINE
Provider Business Mailing Address
First Line : 3620 LONG BEACH BLVD STE A
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-4022
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3620 LONG BEACH BLVD STE A1
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-6014
Country : US
Telephone Number : 562-595-0912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2023
Last Update Date : 01/27/2023

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Directions to “ KARISSA TANIMINE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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