Provider Demographics
NPI:1669652368
Name:GARDUNO, JOCELYN
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:
Last Name:GARDUNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:BLDG.11
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92702-0355
Mailing Address - Country:US
Mailing Address - Phone:714-562-1766
Mailing Address - Fax:714-562-1773
Practice Address - Street 1:6301 BEACH BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2840
Practice Address - Country:US
Practice Address - Phone:714-562-1766
Practice Address - Fax:714-562-1773
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540257163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health