Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
May 25, 2022
License(s)
95021009 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1324 1/2 N SERRANO AVE | Los Angeles, CA 90027-5608 | 205-527-8476 |
| LOCATION | 10200 SEPULVEDA BLVD STE 140 | Mission Hills, CA 91345-3323 | 818-810-6536 |
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