Individual
JESSICA GAETA WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1140 W LA VETA AVE, ORANGE, CA 92868
(714) 543-5555
Mailing address
1140 E LA VETA AVE, STE 430, ORANGE, CA 92868-4226
(714) 543-5555
(714) 836-2427
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
832207
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95003103
CA
Other
Enumeration date
05/22/2015
Last updated
11/02/2021
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