John T Siregar Valid NPI

Individual provider · Registered Nurse · San Bernardino, CA

NPI

1811387574

Type

Individual (Type 1)

Primary specialty

Registered Nurse

Specialty group

Nursing Service Providers

Taxonomy code

163W00000X

License number

820926 (CA)

Sex

Female

Sole proprietor

No

Enumerated

2015-02-02

Last updated

2015-02-02