Individual
JESSE JAMES VAN LEEUWEN-BELOUSSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-C, ACNP
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(619) 543-6886
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP20935
CA
Other
Enumeration date
10/27/2011
Last updated
09/21/2017
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