Individual
MRS. JUSTINE ELISE DELLA FAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNM, WHNP-BC
Contact information
Practice address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(973) 655-4361
Mailing address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
26NJ00722400
NJ
363LW0102X
Women's Health Nurse Practitioner
Primary
95006045
CA
Other
Enumeration date
08/12/2016
Last updated
02/01/2021
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