Individual
JUSTIN REAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19942 CRYSTAL HILLS LN, PORTER RANCH, CA 91326-3897
(818) 667-1036
Mailing address
19942 CRYSTAL HILLS LN, PORTER RANCH, CA 91326-3897
(818) 667-1036
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95032973
CA
Other
Enumeration date
12/14/2024
Last updated
12/14/2024
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