Provider Demographics
NPI:1487395380
Name:TUILAEPA, JANICE VICTORIA
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:VICTORIA
Last Name:TUILAEPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:V
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5555 E STEARNS ST STE 107
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3164
Mailing Address - Country:US
Mailing Address - Phone:562-320-2213
Mailing Address - Fax:
Practice Address - Street 1:200 PINE AVE STE 400
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-3039
Practice Address - Country:US
Practice Address - Phone:562-320-2213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator