Provider Demographics
NPI:1922970888
Name:SIERRA, PETRA MARIA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:PETRA
Middle Name:MARIA
Last Name:SIERRA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21413 DARTMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-2337
Mailing Address - Country:US
Mailing Address - Phone:562-708-2012
Mailing Address - Fax:
Practice Address - Street 1:3620 LONG BEACH BLVD STE C7
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-6013
Practice Address - Country:US
Practice Address - Phone:213-290-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034998363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty