Individual
ALEXANDRA LAUREN PETTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1800 WESTERN AVE STE 204, SAN BERNARDINO, CA 92411-1353
(909) 474-9952
Mailing address
945 S RIDGECREST CIR, ANAHEIM, CA 92807-4502
(256) 620-1972
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95028213
CA
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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