Individual
MRS. NANCY NINA GARRETTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2015 W 1ST ST STE K, SANTA ANA, CA 92703-3516
(714) 547-7745
Mailing address
3125 KALLIN AVE, LONG BEACH, CA 90808-4204
(213) 923-4074
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01124
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0063230
—
CA
Enumeration date
02/02/2007
Last updated
07/09/2007
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