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Individual

CRISTAL VERGARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
9206 SAN MIGUEL AVE APT B, SOUTH GATE, CA 90280-4839
(323) 351-5773
Mailing address
9206 SAN MIGUEL AVE APT B, SOUTH GATE, CA 90280-4839
(323) 351-5773

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
732334
CA
164X00000X
Licensed Vocational Nurse
Primary
732334
CA

Other

Enumeration date
12/07/2023
Last updated
12/07/2023
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