Individual
LAURA JUANITA WILLINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9890 COUNTY FARM RD STE 1, RIVERSIDE, CA 92503-3678
(951) 358-6031
Mailing address
9890 COUNTY FARM RD STE 1, RIVERSIDE, CA 92503-3678
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
730497
CA
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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