Organization
ADVANCED PRACTICE WOUND CARE AND PSYCHE SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAZMEEN INGUITO (OWNER/AUTHORIZED OFFICIAL)
(626) 347-8548
Entity
Organization
Contact information
Practice address
10970 ARROW ROUTE, #214, RANCHO CUCAMONGA, CA 91730
(626) 347-8548
Mailing address
10970 ARROW ROUTE, #214, RANCHO CUCAMONGA, CA 91730
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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