Individual
CLINT LEVIS NGASSEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11162 PALM TERRACE LN, RIVERSIDE, CA 92505-2338
(951) 687-7330
Mailing address
1699 E WASHINGTON ST APT 2174, COLTON, CA 92324-4699
(909) 780-5399
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95034752
CA
Other
Enumeration date
04/17/2025
Last updated
04/17/2025
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