Individual
JOETTA DESWARTE WALLCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2653 ELM AVE, SUITE 200, LONG BEACH, CA 90806-1652
(562) 728-5000
(562) 595-5296
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7900
(323) 361-2337
(323) 361-8491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
244499
CA
363L00000X
Nurse Practitioner
Primary
15928
CA
364S00000X
Clinical Nurse Specialist
787
CA
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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