Individual
MRS. CAROL ANNE MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-CS
Contact information
Practice address
1695 S. SAN JACINTO AVE., HEMET, CA 92583
(951) 665-1440
(818) 696-2590
Mailing address
22400 GAVILAN RD, PERRIS, CA 92570
(951) 780-8565
(951) 780-7344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN235312
CA
163WC1500X
Community Health Registered Nurse
PHN48338
CA
164X00000X
Licensed Vocational Nurse
VN46925
CA
363LF0000X
Family Nurse Practitioner
Primary
NP11416
CA
364SG0600X
Gerontology Clinical Nurse Specialist
CNS1131
CA
Other
Enumeration date
03/18/2007
Last updated
07/19/2011
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