Provider Demographics
NPI:1902132152
Name:HUANG, BLYTHE KATHLEEN (MSN, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:BLYTHE
Middle Name:KATHLEEN
Last Name:HUANG
Suffix:
Gender:F
Credentials:MSN, ACNP-BC
Other - Prefix:
Other - First Name:BLYTHE
Other - Middle Name:KATHLEEN
Other - Last Name:CORBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5161 CALIFORNIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617-8002
Mailing Address - Country:US
Mailing Address - Phone:949-558-1093
Mailing Address - Fax:949-600-9616
Practice Address - Street 1:5161 CALIFORNIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92617-8002
Practice Address - Country:US
Practice Address - Phone:949-558-1093
Practice Address - Fax:949-600-9616
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19179363LA2100X
CA603869163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine