Individual
MRS. JEAN NEPOMUCENO CARLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
415 OLD NEWPORT BLVD, SUITE 200, NEWPORT BEACH, CA 92663-4248
(949) 548-9611
(949) 548-9958
Mailing address
415 OLD NEWPORT BLVD, SUITE 200, NEWPORT BEACH, CA 92663-4248
(949) 548-9611
(949) 548-9958
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN570100
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
NP15130
CA
Other
Enumeration date
04/25/2006
Last updated
11/02/2010
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