Individual
JORDAN MARIE MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 428-1131
Mailing address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 428-1131
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
722083
CA
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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