Healthcare Provider Details

I. General information

NPI: 1891007241
Provider Name (Legal Business Name): JULIE-ANN SABIO GALANG NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 BROCKTON AVE SUITE 107
RIVERSIDE CA
92501-4090
US

IV. Provider business mailing address

4500 BROCKTON AVE SUITE 107
RIVERSIDE CA
92501-4090
US

V. Phone/Fax

Practice location:
  • Phone: 951-276-2760
  • Fax: 949-276-7960
Mailing address:
  • Phone: 951-276-2760
  • Fax: 949-276-7960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18719
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: