Individual
JILL E. MAITEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2701 ATLANTIC AVE, SUITE A, LONG BEACH, CA 90806-2701
(562) 989-8449
(562) 989-8679
Mailing address
11272 LAMPSON AVE, GARDEN GROVE, CA 92840-5323
(714) 636-3144
(714) 636-8703
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
529329
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
529329
NURSE PRACTITIONER
CA
Enumeration date
11/03/2006
Last updated
07/08/2007
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