Georgina Laus Villacorta, Nurse Practitioner
Nurse Practitioner, Family in Riverside, CA. Individual provider (NPI-1).
NPI number1174192512
StatusActive
Last updated in NPPESJun 17, 2024
Details
- NPI
- 1174192512
- Entity type
- Individual (NPI-1)
- Name
- Georgina Laus Villacorta
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 21, 2021
- Certification date
- Jun 17, 2024
- Last updated
- Jun 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 95020330 | CA | Yes |
| 163W00000X | Registered Nurse | 606009 | CA |
Practice location
8070 Jurupa AvenueRiverside, CA 92506
Phone 155-499-1933
Mailing address
4070 Jurupa AveRiverside, CA 92506-2234
Phone 951-808-2422
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All 197 Family Nurse Practitioner providers in Riverside · All 16,640 providers in Riverside
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