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Individual

LEEZA CAMACHO WILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1140 W LA VETA AVE STE 770, ORANGE, CA 92868-4229
(714) 835-8715
Mailing address
1140 W LA VETA AVE STE 770, ORANGE, CA 92868-4229
(714) 835-8715

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
462152
CA
363LW0102X
Women's Health Nurse Practitioner
Primary
NP95008565
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33-0150193
MEDI-CAL
CA
Enumeration date
08/08/2013
Last updated
08/03/2022
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