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1164848933
EVANGELINE VISTE
SAN DIEGO, CA
NPI
1164848933
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: CA 23592)
Enumeration Date
2014-03-17
Last Update Date
2017-04-10
Business Address
EVANGELINE VISTE
7035 CONVOY CT
SAN DIEGO, CA 92111-1016
Phone number: 858-573-0090
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Mailing Address
EVANGELINE VISTE
24661 LA CRESTA DR APT 8
DANA POINT, CA 92629-2557
Phone number:
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