Healthcare Provider Details

I. General information

NPI: 1083531628
Provider Name (Legal Business Name): MS. GENEVIEVE JOCELYN DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 S EREMLAND DR
COVINA CA
91723-3100
US

IV. Provider business mailing address

540 S EREMLAND DR
COVINA CA
91723-3100
US

V. Phone/Fax

Practice location:
  • Phone: 626-966-1577
  • Fax: 626-331-4529
Mailing address:
  • Phone: 626-966-1577
  • Fax: 626-331-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: