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1043931629
JETTELE JOY D LARA
WEST COVINA, CA
NPI
1043931629
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: CA 95019623)
Enumeration Date
2022-09-12
Last Update Date
2024-02-01
Business Address
JETTELE JOY D LARA FNP-C
1135 S SUNSET AVE STE 401
WEST COVINA, CA 91790-3921
Phone number: 626-732-8393
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Mailing Address
JETTELE JOY D LARA FNP-C
1405 PARTRIDGE LN
GLENDORA, CA 91740-4529
Phone number: 626-347-2988
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