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1013620715
JACKELINE PORTILLO
VAN NUYS, CA
NPI
1013620715
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: CA 700603)
Enumeration Date
2022-12-28
Last Update Date
2022-12-28
Business Address
JACKELINE PORTILLO
7515 VAN NUYS BLVD
VAN NUYS, CA 91405-1949
Phone number: 818-627-3067
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Mailing Address
JACKELINE PORTILLO
7515 VAN NUYS BLVD
VAN NUYS, CA 91405-1949
Phone number: 818-627-3000
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