Individual
JOSEPH ASHIMEDUA MODESTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
6200 WILSHIRE BLVD STE 1410, LOS ANGELES, CA 90048-5815
(925) 282-1778
(415) 296-5299
Mailing address
6200 WILSHIRE BLVD STE 1410, LOS ANGELES, CA 90048-5815
(925) 282-1778
(415) 296-5299
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2020037670
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95016877
CA
Other
Enumeration date
11/03/2020
Last updated
06/26/2024
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