Most Relevant Information
Provider Data
| NPI Number: | 1003299033 |
| Provider Name: | JESSICA WANG NURSE PRACTITIONER |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 95002105 |
Most Important Dates
| Enumeration Date: | 07/08/2015 |
| Last Updated: | 07/12/2024 |
Provider Practice Location
230 E VALLEY BLVD
SUITE 200
SAN GABRIEL
CA
917766510
Practice Location Phone/Fax
| Phone: | 6262881918 |
| Fax: |
Provider Mailing Location
22715 MOUNTAIN LAUREL WAY
DIAMOND BAR
CA
917652527
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |