Individual
EDUARDO LONGSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1481 WINDSOR DR, SAN BERNARDINO, CA 92404-5416
(909) 361-6470
Mailing address
14135 MAIN ST STE 301, HESPERIA, CA 92345-8095
(760) 947-3257
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95182846
CA
363L00000X
Nurse Practitioner
95025356
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95025356
CA
Other
Enumeration date
03/21/2022
Last updated
02/17/2026
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