Individual
JACQUELINE M HOOGERVORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(951) 486-4000
Mailing address
33034 CLAIRETTE CT, WINCHESTER, CA 92596-4523
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
784279
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
95024083
CA
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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