Individual
MRS. CAROLYN JOYCE WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITONER
Contact information
Practice address
351 S HUDSON AVE, PASADENA, CA 91101-3507
(626) 795-6981
(626) 584-1540
Mailing address
4082 DENVER AVE, YORBA LINDA, CA 92886-1944
(714) 524-6756
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
245433
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SS1964881
—
CA
Enumeration date
02/20/2007
Last updated
07/09/2007
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