Individual
CAROL CISNEROS-RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1200 N STATE ST RM 10850 A, LOS ANGELES, CA 90033-1029
(323) 226-7655
(323) 229-5996
Mailing address
1200 N STATE ST RM 10850 A, LOS ANGELES, CA 90033-1029
(323) 226-7655
(323) 229-5996
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN 301799
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
301799
CA
Other
Enumeration date
06/12/2007
Last updated
10/27/2017
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