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PEARL GRACE NACIONALES ESMALLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
545 LAUREL ST, SAN DIEGO, CA 92101-1634
(619) 233-4399
Mailing address
545 LAUREL ST, SAN DIEGO, CA 92101-1634

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95038580
CA
164X00000X
Licensed Vocational Nurse
223269
CA

Other

Enumeration date
03/24/2012
Last updated
09/16/2014
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