Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vivian Tanudjaja

Individual provider Athletic Trainer · NPI 1831692086

Vivian Tanudjaja is an Athletic Trainer in Long Beach, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018

Practice location Address checks out

6481 Atlantic Ave Apt 135
Long Beach, CA 90805-2339
Phone: (562) 612-5696
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X (CA)

Record details

NPI number1831692086
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 14, 2018
Last updated in NPPESMarch 14, 2018

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