Provider Demographics
NPI:1053714360
Name:JALOMO, JUANITA ISABEL (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:ISABEL
Last Name:JALOMO
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 E DANENBERG DR
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-8517
Mailing Address - Country:US
Mailing Address - Phone:760-344-9951
Mailing Address - Fax:760-344-1629
Practice Address - Street 1:2133 WINTERHAVEN DR
Practice Address - Street 2:
Practice Address - City:WINTERHAVEN
Practice Address - State:CA
Practice Address - Zip Code:92283-9609
Practice Address - Country:US
Practice Address - Phone:760-538-3073
Practice Address - Fax:760-205-0016
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95010669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily