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1427567049
JACQUELYNN BANABAN
TORRANCE, CA
NPI
1427567049
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: CA 95007291)
Enumeration Date
2017-09-26
Last Update Date
2017-09-26
Business Address
JACQUELYNN BANABAN AG-ACNP-BC
1000 W CARSON ST # 2
TORRANCE, CA 90502-2004
Phone number: 310-222-2171
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Mailing Address
JACQUELYNN BANABAN AG-ACNP-BC
2234 CLOVERFIELD BLVD
SANTA MONICA, CA 90405-1821
Phone number: 808-349-8152
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