Individual
JONAH BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 S LYON ST APT 234, SANTA ANA, CA 92705-7278
(949) 306-2054
Mailing address
710 S LYON ST APT 234, SANTA ANA, CA 92705-7278
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
287625
CA
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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