Individual
LORI JO GRESOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3175 FIRESTONE BLVD, SOUTH GATE, CA 90280-2951
(949) 929-4165
(323) 923-5460
Mailing address
3175 FIRESTONE BLVD, SOUTH GATE, CA 90280-2951
(949) 929-4165
(323) 923-5460
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
NP12408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00NP12408
—
CA
Enumeration date
12/07/2016
Last updated
12/07/2016
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