Individual
VLESS TRINIDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1411
Mailing address
297 S SIERRA MADRE BLVD APT 105, PASADENA, CA 91107-4885
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95012459
CA
Other
Enumeration date
01/23/2021
Last updated
01/23/2021
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