Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Aug 24, 2010
License(s)
633683 (CA), 19394 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2141 N HARBOR BLVD STE 25000 | Fullerton, CA 92835-3830 | 714-349-5674 |
| MAILING | 2141 N HARBOR BLVD STE 25000 | Fullerton, CA 92835-3830 | 714-349-5674 |
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