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1366169476
NICOLE MARIE SOUSA SANTOS
LAGUNA HILLS, CA
NPI
1366169476
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: NY F349759)
Enumeration Date
2022-10-20
Last Update Date
2022-10-20
Business Address
NICOLE MARIE SOUSA SANTOS
3141 MOULTON PKWY SUITE 102
LAGUNA HILLS, CA 92653
Phone number: 949-916-9100
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Mailing Address
NICOLE MARIE SOUSA SANTOS
57 OSAGE ST
SELDEN, NY 11784-2729
Phone number: 631-942-8458
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