LEGACY ADVANCED NURSING PRACTICE INCORPORATED
NPI 1548905391
Nurse Practitioner - Psychiatric/Mental Health in Anaheim, CA

Q: What is Legacy Advanced Nursing Practice Incorporated's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since May 04, 2022

710 N EUCLID ST STE 208, ANAHEIM, CA 92801(714) 844-5804(714) 888-7216 Get Directions Write a Review

NPPES record last updated: December 29, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 29, 2022, May 7, 2022 (2 updates tracked since 2022).

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About Legacy Advanced Nursing Practice Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY ADVANCED NURSING PRACTICE INCORPORATED (NPI 1548905391) is a healthcare organization registered as a psychiatric/mental health in Anaheim, California and active in the NPI registry since May 2022. The organization lists Tyisha Renee Fletcher, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1548905391

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameLEGACY ADVANCED NURSING PRACTICE INCORPORATED

Location Address710 N EUCLID ST STE 208Anaheim, CA 92801-4132

Mailing Address5318 E 2nd St # 339Long Beach, CA 90803-5324 · (310) 251-6727

Phone(714) 844-5804

Fax(714) 888-7216

Organization SubpartNo

Authorized OfficialTyisha Renee FletcherNurse Practitioner · (310) 251-6727

Enumeration DateMay 4, 2022

Last NPPES UpdateDecember 29, 20222 updates tracked since enumeration

NPPES CertifiedDecember 29, 2022

✔ NPI 1548905391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

710 N EUCLID ST STE 208, Anaheim, CA 92801

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Legacy Advanced Nursing Practice Incorporated is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Legacy Advanced Nursing Practice Incorporated, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tyisha Fletcher, PMHNP - BC

Nurse Practitioner

NPI 1144687047

4500 E PACIFIC COAST HWY STE 320
Long Beach, CA 90804

(925) 282-1778

✔ PECOS✔ Accepts Medicare12 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Advanced Nursing Practice Incorporated's NPI number?

The NPI number for Legacy Advanced Nursing Practice Incorporated is 1548905391. It was assigned to this organization in the NPPES registry on May 4, 2022.

Where is Legacy Advanced Nursing Practice Incorporated located?

Legacy Advanced Nursing Practice Incorporated is located at 710 N Euclid St Ste 208, Anaheim, CA 92801. The listed phone number is (714) 844-5804.

What is Legacy Advanced Nursing Practice Incorporated's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Legacy Advanced Nursing Practice Incorporated enrolled in Medicare?

Yes. Legacy Advanced Nursing Practice Incorporated is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Legacy Advanced Nursing Practice Incorporated?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Legacy Advanced Nursing Practice Incorporated. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Legacy Advanced Nursing Practice Incorporated was last updated on December 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.