GISELLE ALICIA MATA

SANTA ANA, CA
NPI1255659892
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: CA  NP19537)
Enumeration Date2010-05-06
Last Update Date2016-05-20
Business Address
-- GISELLE ALICIA MATA FNP
1212 W 17TH ST
SANTA ANA, CA 92706-3418
Phone number: 714-377-2348
Mailing Address
-- GISELLE ALICIA MATA FNP
17360 BROOKHURST STREET ATTN: CREDENTIALING DEPT.
FOUNTAIN VALLEY, CA 92708-3720
Phone number: 657-241-3592
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