Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Feb 11, 2026
License(s)
95338170 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 13932 SUMMERWOOD PL | Garden Grove, CA 92844-2564 | |
| LOCATION | 13932 SUMMERWOOD PL | Garden Grove, CA 92844-2564 | 714-642-4187 |
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