Individual
MS. RAYVEION LAQUITA MEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
40 CEDAR WALK UNIT 2115, LONG BEACH, CA 90802-7922
(562) 481-4850
Mailing address
40 CEDAR WALK UNIT 2115, LONG BEACH, CA 90802-7922
(562) 481-4850
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95010266
CA
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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