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Individual

GENEVIEVE WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP-BC

Contact information

Practice address
1316 3RD STREET PROMENADE, SUITE 201, SANTA MONICA, CA 90401-1328
(800) 576-5544
Mailing address
20 MELA LN, RANCHO PALOS VERDES, CA 90275-5084
(310) 924-9195

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95062564
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
95003281
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95003281
CA NURSE PRACTITIONER LICENSE NUMBER
CA
01
95062564
CA REGISTERED NURSE LICENSE NUMBER
CA
Enumeration date
10/20/2015
Last updated
10/20/2015
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