Vivere Jabonillo Castro
Nurse Practitioner, Family in West Covina, CA. Individual provider (NPI-1).
NPI number1154087641
StatusActive
Last updated in NPPESMay 7, 2024
Details
- NPI
- 1154087641
- Entity type
- Individual (NPI-1)
- Name
- Vivere Jabonillo Castro
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 9, 2021
- Certification date
- Nov 21, 2023
- Last updated
- May 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 95019100 | CA | Yes |
Practice location
1115 S Sunset Ave Ste 200West Covina, CA 91790-3940
Phone 626-732-8390
Mailing address
14011 Park AveVictorville, CA 92392-2413
Phone 833-574-2273
Other practice locations
9961 Sierra Ave
Fontana, CA 92335-6720
Fontana, CA 92335-6720
Phone 909-302-6254
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