MEDICARE: JULIANA RESUELLO LABRADOR MSN-FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95024594	CA
2	363L00000X	Nurse Practitioner	95024594	CA

General Provider Information

NPI Number	:	1629759659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA RESUELLO LABRADOR MSN-FNP

Provider Business Mailing Address
First Line	:	12966 EUCLID ST STE 110
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92840-9203
Country	:	US
Telephone Number	:	404-408-5442
Fax Number	:

Provider Business Practice Location Address
First Line	:	12966 EUCLID ST STE 110
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92840-9203
Country	:	US
Telephone Number	:	720-204-5760
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	02/06/2025

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