Individual provider · Type 1 NPI
Jonathan Edward Panuelos Evidente
Psychiatric/Mental Health Registered Nurse · Orange, CA
NPI number
1447849104
Active
Practice location
265 S Anita Dr Ste 102-104
Orange, CA 92868-3355
Fax (310) 945-3356
Mailing address
9808 Venice Blvd Ste 505
Culver City, CA 90232-6818
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Registered Nurse Primary | 163WP0808X | 95285762 (CA) |
Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1447849104
Jonathan Edward Panuelos Evidente's National Provider Identifier is 1447849104, issued on Jan 15, 2021. The primary taxonomy on file is Psychiatric/Mental Health Registered Nurse (163WP0808X), and the practice location is in Orange, CA. The record was last updated on Dec 12, 2023.