Individual
ELIZABETH ANN CUSTODIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
170 S MAIN ST, ORANGE, CA 92868-2801
(714) 288-7651
Mailing address
38919 HUDDLESTONE CT, MURRIETA, CA 92563-2589
(951) 894-6484
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95010582
CA
Other
Enumeration date
07/24/2020
Last updated
11/27/2023
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