Individual
ALEXANDRA BANUELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE/ PSYCHIATRIC T
Contact information
Practice address
330 E LIVE OAK AVE, ARCADIA, CA 91006-5617
(626) 827-0756
Mailing address
4733 MAXSON RD, EL MONTE, CA 91732-1741
(626) 575-8873
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
VN156396
CA
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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