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Individual

MRS. EUSEBIA BALLESTERO CHANGCOCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
12237 HILLSDALE AVE, VILLAGE GREEN, SYLMAR, CA 91342-5136
(818) 833-8028
Mailing address
12237 HILLSDALE AVE, VILLAGE GREEN, SYLMAR, CA 91342-5136
(818) 833-8028

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
724372
CA

Other

Enumeration date
08/12/2013
Last updated
08/12/2013
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