IVETTE SYRA JACKSON

WEST HOLLYWOOD, CA
NPI1699036756
Former NameIVETTE SYRA YAMAMOTO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LN0005X Nurse Practitioner, Neonatal, Critical Care
(Licence: CA  95007329)
Additional Taxonomies363LN0005X Nurse Practitioner, Neonatal, Critical Care
(Licence: NE  111345)
363LN0005X Nurse Practitioner, Neonatal, Critical Care
(Licence: FL  ARNP 9350748)
Enumeration Date2012-06-06
Last Update Date2020-09-24
Business Address
IVETTE SYRA JACKSON APRN-NP
8700 BEVERLY BLVD # 4311
WEST HOLLYWOOD, CA 90048-1804
Phone number: 310-423-4451
Mailing Address
IVETTE SYRA JACKSON APRN-NP
4140 W 190TH ST
TORRANCE, CA 90504-5513
Phone number: 310-423-4451