Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Dec 17, 2021
License(s)
95019499 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 10118 SAMOA AVE APT 7 | Tujunga, CA 91042-3546 | 323-919-1830 |
| LOCATION | 1172 N MACLAY AVE | San Fernando, CA 91340-1328 | 818-898-1388 |
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