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Individual

MR. BENJAMIN JACOB FESAGAIGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
1975 LONG BEACH BLVD, LONG BEACH, CA 90806-5501
(562) 599-9401
Mailing address
22917 ARCHIBALD AVE, CARSON, CA 90745-4716

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
519452
CA

Other

Enumeration date
01/03/2007
Last updated
07/08/2007
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