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Individual

ELLIS NINONUEVO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1215 E CHAPMAN AVE, ORANGE, CA 92866-2237
(714) 583-6431
(714) 912-7432
Mailing address
3942 ACACIA ST, IRVINE, CA 92606-2628
(949) 861-0316

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN 401698
CA

Other

Enumeration date
09/29/2016
Last updated
09/29/2016
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