Individual
MS. WILLIE JEAN VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5233 CASTANA ST, SAN DIEGO, CA 92114-3717
(619) 784-7700
Mailing address
5233 CASTANA ST, SAN DIEGO, CA 92114-3717
(619) 784-7700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
RN383888
CA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
383888
CA
Other
Enumeration date
04/03/2009
Last updated
11/19/2015
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