Individual
PING ANTARAN DESEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-2365
Mailing address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-2365
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
745421
CA
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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