Provider Demographics
NPI:1306342860
Name:TIRPAK, ELIZABETH THERESE (FNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:THERESE
Last Name:TIRPAK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 OLD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2837
Mailing Address - Country:US
Mailing Address - Phone:562-756-8265
Mailing Address - Fax:
Practice Address - Street 1:2110 N BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3126
Practice Address - Country:US
Practice Address - Phone:562-346-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily