Individual
AISHAH MANDEEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
14971 HOLT AVE, TUSTIN, CA 92780-3406
(949) 356-7676
Mailing address
13446 WARREN PL, VICTORVILLE, CA 92395-8660
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95011055
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95011055
CALIFORNIA BOARD OF REGISTERED NURSING
CA
Enumeration date
02/01/2019
Last updated
02/24/2023
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