Individual provider · Type 1 NPI

Conchita Esther Portilla, NURSE PRACTITIONER P

Pediatric Nurse Practitioner · Colton, CA

NPI number 1649232075 Active

Practice location

400 N Pepper Ave, Pediatrics Administration
Colton, CA 92324-1819

Fax (909) 580-3235

Mailing address

400 N. Pepper Ave., Pediatrics Administration
Colton, CA 92324-1819

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X402401 (CA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1649232075

Conchita Esther Portilla, NURSE PRACTITIONER P's National Provider Identifier is 1649232075, issued on Apr 3, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Colton, CA. The record was last updated on Dec 22, 2014.