Individual
MR. JOSE DESTAJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
14238 SARANAC LN, SYLMAR, CA 91342-1435
(818) 485-0888
(818) 833-5690
Mailing address
9938 SWINTON AVE, NORTH HILLS, CA 91343-1328
(818) 634-1077
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
745368
CA
Other
Enumeration date
03/25/2015
Last updated
11/01/2022
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