| NPI | 1063920296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JOY PORCIUNCULA President 818-433-0262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005617) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2024-06-11 |