Individual
JENNY AGTARAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21816 1/2 GRACE AVE, CARSON, CA 90745-3272
(424) 283-1838
Mailing address
21816 1/2 GRACE AVE, CARSON, CA 90745-3272
(424) 283-1838
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN278257
CA
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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