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Individual

BERESA URGESSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-3145
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95244841
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95037698
CA

Other

Enumeration date
04/04/2023
Last updated
01/02/2026
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