Individual
JENNIFER MACCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2071 SAN JOAQUIN HILLS RD, NEWPORT BEACH, CA 92660-6505
(949) 759-1720
(949) 759-1442
Mailing address
24422 AVENIDA DE LA CARLOTA STE 300, LAGUNA HILLS, CA 92653-3628
(949) 599-2434
(949) 599-2430
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
95011121
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
95015296
CA
363LP0200X
Pediatric Nurse Practitioner
RN9315548
FL
Other
Enumeration date
07/15/2013
Last updated
03/02/2022
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