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NIMNEH JACKSON-VAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1370 N STATE ST, SUITE A, SAN JACINTO, CA 92583-4943
(951) 791-3330
Mailing address
1370 S STATE ST STE A, SAN JACINTO, CA 92583-4922
(951) 791-3330

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
763466
CA

Other

Enumeration date
06/10/2024
Last updated
06/18/2024
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