Individual
JESSICA WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
230 E VALLEY BLVD, SUITE 200, SAN GABRIEL, CA 91776-6510
(626) 288-1918
Mailing address
22715 MOUNTAIN LAUREL WAY, DIAMOND BAR, CA 91765-2527
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95002105
CA
Other
Enumeration date
07/08/2015
Last updated
07/12/2024
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