Individual
BIANCA TALAVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4335 ATLANTIC AVE, LONG BEACH, CA 90807-2803
(562) 216-4900
Mailing address
9808 VENICE BLVD., STE. 505, CULVER CITY, CA 90232-2803
(562) 216-4900
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
941735271
—
CA
Enumeration date
06/01/2015
Last updated
09/08/2017
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