Individual
JACQUELINE OVSEPYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
808 W 58TH ST FL 2, LOS ANGELES, CA 90037-3632
(323) 541-1600
Mailing address
808 W 58TH ST FL 2, LOS ANGELES, CA 90037-3632
(323) 541-1600
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
833253
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95016443
CA
Other
Enumeration date
08/28/2020
Last updated
07/16/2021
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