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Individual

DEIDRE KAWAMOTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
10580 BRUNS DR, TUSTIN, CA 92782-1413
(714) 722-0203
Mailing address
10580 BRUNS DR, TUSTIN, CA 92782-1413
(714) 722-0203

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F09250798
CA

Other

Enumeration date
09/23/2025
Last updated
09/23/2025
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