Individual
VIVIAN IFEDIORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1902 W 133RD ST, COMPTON, CA 90222-1622
(310) 382-4882
Mailing address
1902 W 133RD ST, COMPTON, CA 90222-1622
(310) 382-4882
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95032026
CA
Other
Enumeration date
12/26/2024
Last updated
12/26/2024
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