Individual
GYSSELL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13115 PEPPERBUSH DR, MORENO VALLEY, CA 92553-0811
(951) 472-7486
Mailing address
13115 PEPPERBUSH DR, MORENO VALLEY, CA 92553-0811
(951) 472-7486
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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