Individual
JUSTINA WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
111 ELM ST, SAN DIEGO, CA 92101-2692
(619) 677-3800
Mailing address
5550 BALBOA ARMS DR APT 18, SAN DIEGO, CA 92117-5048
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95020317
CA
363LG0600X
Gerontology Nurse Practitioner
95020317
CA
Other
Enumeration date
03/15/2022
Last updated
03/15/2022
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