Individual
NINA GABRIELE SITOMPUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 WILSHIRE BLVD, LOS ANGELES, CA 90057-4303
(213) 639-2660
Mailing address
10593 HORSESHOE DR, BLOOMINGTON, CA 92316-2767
(909) 714-0046
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT33479
CA
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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