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Individual

MRS. JODY L. CHURCH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.N.P.

Contact information

Practice address
12540 PIERCE ST, PACOIMA, CA 91331-1701
(818) 897-2193
(818) 899-3864
Mailing address
1172 N MACLAY AVE, SAN FERNANDO, CA 91340-1328
(818) 898-1388
(818) 365-4031

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
171
CA

Other

Enumeration date
08/02/2005
Last updated
07/08/2007
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