JUSAC SURYANATA

OCEANSIDE, CA
NPI1124897046
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA  95166131)
Additional Taxonomies363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA  95031637)
Enumeration Date2023-12-20
Last Update Date2024-08-12
Business Address
JUSAC SURYANATA RN
3308 CAROLYN CIR
OCEANSIDE, CA 92054-3844
Phone number: 760-658-4405
Mailing Address
JUSAC SURYANATA RN
3308 CAROLYN CIR
OCEANSIDE, CA 92054-3844
Phone number: 760-658-4405