Individual
MRS. JACQUELINE R. PROPHETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5300 ANGELES VISTA BLVD, LOS ANGELES, CA 90043
(323) 295-4555
(323) 295-3021
Mailing address
5300 ANGELES VISTA BLVD, LOS ANGELES, CA 90043
(323) 295-4555
(323) 295-3021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN507420
CA
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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