Individual
ALMA LICON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1224 VINE ST, LOS ANGELES, CA 90038-1612
(323) 856-5763
Mailing address
1224 VINE ST, LOS ANGELES, CA 90038-1612
(323) 856-5763
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
596984
CA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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