Most Relevant Information
Provider Data
| NPI Number: | 1003691957 |
| Provider Name: | WANDA JEANETTE DEQUARDO DNP, APRN, FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 95129597 |
Most Important Dates
| Enumeration Date: | 08/29/2023 |
| Last Updated: | 12/13/2023 |
Provider Practice Location
17822 BEACH BLVD STE 300
HUNTINGTON BEACH
CA
926477172
Practice Location Phone/Fax
| Phone: | 7143751122 |
| Fax: | 9498638581 |
Provider Mailing Location
28176 COULTER
MISSION VIEJO
CA
926924064
Provider Mailing Phone/Fax
| Phone: | 9492018307 |
| Fax: |