| NPI | 1992390629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLORDELIS DELACRUZ Registered Agent 619-948-4403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-05-07 |