Individual
KIBIBI SHANI GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6229 BUTLER AVE, LONG BEACH, CA 90805-2238
(562) 234-9898
Mailing address
6229 BUTLER AVE, LONG BEACH, CA 90805-2238
(562) 234-9898
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
33827
CA
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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