Individual
MRS. COLLEEN MARIE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
30210 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-1574
(949) 493-7337
(949) 493-1418
Mailing address
24422 AVENIDA DE LA CARLOTA STE 300, LAGUNA HILLS, CA 92653-3628
(949) 599-2434
(949) 599-2430
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
357546
CA
Other
Enumeration date
08/08/2011
Last updated
05/26/2022
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