Individual provider · Type 1 NPI

Georgina Laus Villacorta, NURSE PRACTITIONER

Family Nurse Practitioner · Riverside, CA

NPI number 1174192512 Active

Practice location

8070 Jurupa Avenue
Riverside, CA 92506

Call (155) 499-1933 Map

Mailing address

4070 Jurupa Ave
Riverside, CA 92506-2234

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X606009 (CA)
Family Nurse Practitioner Primary 363LF0000X95020330 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1174192512

Georgina Laus Villacorta, NURSE PRACTITIONER's National Provider Identifier is 1174192512, issued on Jun 21, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Riverside, CA. The record was last updated on Jun 17, 2024.