Individual
MISS ANNA LIZA CELSO BASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1465 E LEXINGTON, UNIT 10-C, EL CAJON, CA 92019
(619) 312-1003
Mailing address
1465 E LEXINGTON, UNIT 10-C, EL CAJON, CA 92019
(619) 312-1003
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
19760
CA
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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