Individual
TESSA GODELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 EBB TIDE CIR, NEWPORT BEACH, CA 92663-2842
(562) 301-2380
Mailing address
22 EBB TIDE CIR, NEWPORT BEACH, CA 92663-2842
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95029997
CA
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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