Individual
OLIVIA JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
17095 MAIN ST, HESPERIA, CA 92345-6004
(760) 956-4113
(760) 948-4616
Mailing address
17095 MAIN ST, HESPERIA, CA 92345-6004
(760) 956-4113
(760) 948-4616
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
95122790
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95122790
CALIFORNIA BOARD OF REGISTERED NURSING
CA
Enumeration date
12/10/2021
Last updated
12/10/2021
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