Individual
SADE WOLDEGIORGIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4211 AVALON BLVD, LOS ANGELES, CA 90011-5622
(323) 233-0425
Mailing address
14050 CHERRY AVE STE R, FONTANA, CA 92337-2002
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
95199346
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95031424
CA
Other
Enumeration date
05/16/2024
Last updated
08/09/2024
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