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Individual

JAYNE KWON-CLAVADETSCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
911 E PLAZA BLVD, NATIONAL CITY, CA 91950-3523
(619) 434-0299
Mailing address
8077 FLORENCE AVE STE 112, DOWNEY, CA 90240-3894
(562) 904-6031
(562) 905-6033

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN-1790
HI
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
95004414
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13998254
CAQH
01
1922400050
NPI
01
95004414
LICENSE
CA
Enumeration date
09/19/2014
Last updated
07/21/2022
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