Individual
IVELISSE JOURDAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
474 S CITRUS AVE, AZUSA, CA 91702-4733
(626) 858-9500
Mailing address
474 S CITRUS AVE, AZUSA, CA 91702-4733
(626) 858-9500
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
707796
CA
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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