Individual
CAROL ANNE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2400 MISSION ST, SAN MARINO, CA 91108
(626) 403-8989
(626) 403-8969
Mailing address
4525 E ATHERTON ST, LONG BEACH, CA 90815-3700
(562) 961-0155
(562) 961-0161
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
23089
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2771086
—
OH
Enumeration date
08/01/2006
Last updated
11/03/2014
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