Individual
JOHANNA CAMILLE DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
14940 CHERRY GROVE CT, TUSTIN, CA 92780-6115
(626) 377-0642
Mailing address
14940 CHERRY GROVE CT, TUSTIN, CA 92780-6115
(626) 377-0642
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1119112
TX
363L00000X
Nurse Practitioner
211096
OK
363L00000X
Nurse Practitioner
95013358
CA
363LF0000X
Family Nurse Practitioner
95013358
CA
Other
Enumeration date
09/21/2022
Last updated
01/09/2025
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