Organization
MAC JANE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET AGU (OWNER)
(562) 565-0699
Entity
Organization
Contact information
Practice address
11200 LUCAS ST, CERRITOS, CA 90703-1626
(562) 565-0699
Mailing address
PO BOX 1214, ARTESIA, CA 90702-1214
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
02/11/2022
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