Individual
KRISTA GUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1161 E COVINA BLVD, COVINA, CA 91724-1523
(626) 859-5275
Mailing address
704 GHENT ST, LA VERNE, CA 91750-3829
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
503725
CA
Other
Enumeration date
11/18/2024
Last updated
11/21/2024
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