Individual
MARK JUSTIN JARABA RUEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
1007 HARRINGTON WAY, WEST COVINA, CA 91792-1021
(714) 883-6264
Mailing address
1007 HARRINGTON WAY, WEST COVINA, CA 91792-1021
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95018894
CA
363LG0600X
Gerontology Nurse Practitioner
95018894
CA
Other
Enumeration date
10/20/2021
Last updated
10/25/2024
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