Individual
MR. MARIO PACHECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
11012 LOCH AVON DR, WHITTIER, CA 90606-1530
(562) 774-5351
Mailing address
11012 LOCH AVON DR, WHITTIER, CA 90606-1530
(562) 774-5351
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
570465
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95000401
CA
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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