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Individual

JEREMY R VERHINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
31877 DEL OBISPO ST STE 205, SAN JUAN CAPISTRANO, CA 92675-3228
(949) 503-1766
(252) 250-2029
Mailing address
32565 GOLDEN LANTERN ST # B479, DANA POINT, CA 92629-3261
(949) 750-7082
(252) 250-2029

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95009393
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003302605
NPI
CA
Enumeration date
07/06/2018
Last updated
08/28/2023
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