Individual
JORDAN AUGUSTINE PATRICIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNPC-AG
Contact information
Practice address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-8358
(424) 465-4601
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95018761
CA
363LA2100X
Acute Care Nurse Practitioner
95018761
CA
Other
Enumeration date
03/13/2025
Last updated
06/02/2025
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