Individual
EBONY KEISHAWN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
9808 VENICE BLVD STE 700, CULVER CITY, CA 90232-6824
(310) 945-3350
(310) 945-3356
Mailing address
9808 VENICE BLVD STE 700, CULVER CITY, CA 90232-6824
(310) 945-3350
(310) 945-3356
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
695991
CA
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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