Individual
MARIA DELIA DEJARME FORTUNATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4211 AVALON BLVD, LOS ANGELES, CA 90011-5622
(323) 233-0425
Mailing address
2041 EAST ST UNIT 805, CONCORD, CA 94520-2126
(213) 377-0012
(213) 377-0044
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
861500
NV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95023985
CA
Other
Enumeration date
12/13/2022
Last updated
10/08/2025
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