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Individual

GEMMA DULOSA BALCITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5838 EDISON PL, CARLSBAD, CA 92008-5520
(888) 515-3834
Mailing address
PO BOX 2443, GARDEN GROVE, CA 92842-2443
(657) 256-8354

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95019380
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529902
CA
Enumeration date
01/26/2022
Last updated
12/26/2022
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