Individual
MS. GISELE FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1419 S. BROADWAY, LOS ANGELES, CA 90013
(213) 485-3362
(213) 485-3429
Mailing address
417 E. TAMARACK AVE, #39, INGLEWOOD, CA 90301-6321
(310) 412-4965
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
299335
CA
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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