Individual
VANESSA SEVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4590 NICOLE WAY, RIVERSIDE, CA 92501-4301
(562) 292-0579
Mailing address
4590 NICOLE WAY, RIVERSIDE, CA 92501-4301
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95008325
CA
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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