NPI 1043931629

Jettele Joy D Lara, FNPC

Practitioner Pediatric Nurse Practitioner West Covina, CA

Practice location

Address: 1135 S Sunset Ave STE 401, West Covina, CA 91790-3921
Phone: (626) 732-8393
Mailing address: 1405 Partridge Ln, Glendora, CA 91740-4529

Registered specialties

Pediatric Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LP0200X Licence 95019623 (CA)

Other Nurse Practitioner providers in California →

Registry record

NPI: 1043931629
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Sep 2022
Record last updated: 1 Feb 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.