MEDICARE: SUNNY PALMS NURSING CORPORATION

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1841068343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNNY PALMS NURSING CORPORATION

Provider Business Mailing Address
First Line	:	1404 E 1ST ST APT 1
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-8208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 E 1ST ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-5730
Country	:	US
Telephone Number	:	415-971-3077
Fax Number	:

Authorized Official
Title or Position	:	PSYCHIATRIC NURSE PRACTITIONER
Name	:	BRANDI CARTER
Credential	:	NP
Telephone Number	:	323-233-0425

Provider Enumeration Date	:	12/13/2023
Last Update Date	:	12/19/2023

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