Individual
JUANDELLETTA COMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1920 MARENGO ST, LOS ANGELES, CA 90033-1317
(844) 221-2276
Mailing address
1920 MARENGO ST, LOS ANGELES, CA 90033-1317
(844) 221-2276
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
193987
CA
164X00000X
Licensed Vocational Nurse
Primary
193987
CA
Other
Enumeration date
01/06/2023
Last updated
07/25/2024
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