ROME DIOSTONNE EVANGELISTA

ENCINO, CA
NPI1144902347
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA  95026297)
Enumeration Date2023-08-07
Last Update Date2024-06-12
Business Address
ROME DIOSTONNE EVANGELISTA NP
16530 VENTURA BLVD STE 400
ENCINO, CA 91436-4551
Phone number: 818-625-4814
Mailing Address
ROME DIOSTONNE EVANGELISTA NP
19525 NORDHOFF ST APT 563
NORTHRIDGE, CA 91324-7427
Phone number: 818-625-4814