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Organization

JESSICA WONG NURSE PRACTITIONER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA WONG (NP)
(714) 457-9905
Entity
Organization

Contact information

Practice address
15024 IMPERIAL HWY, LA MIRADA, CA 90638-1301
(714) 457-9905
Mailing address
15024 IMPERIAL HWY, LA MIRADA, CA 90638-1301
(714) 457-9905

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
11/08/2023
Last updated
07/11/2024
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