Julie Auxenia Ballesteros Agojo, R.N.

Individual provider Active NPI Registered Nurse · Walnut, CA

NPI 1275833170 · NPPES record last updated Oct 25, 2010

Key facts

NPI
1275833170
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
288352 (CA)
Practice address
19200 Lydle Creek PL
Walnut, CA 91789-4302
Phone
(213) 738-3787
Fax
(213) 351-2491
NPI assigned
Oct 25, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
288352CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 288352 CA Yes

Addresses

Primary practice location

19200 Lydle Creek PL
Walnut, CA 91789-4302

Mailing address

19200 Lydle Creek PL
Walnut, CA 91789-4302
Phone (213) 738-3787

Other providers in Walnut, CA

All providers in Walnut, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.