Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95019830 | CA |
NPI | 1003560962 |
---|---|
Provider Name | Isabella Jusay |
First Address | Los Angeles, CA 90059-3026 |
Second Address | Los Angeles, CA 90059-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2022 |
Last Update Date | 09/02/2022 |