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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JAESON M FETALVERO

Active Sole Proprietor

JAESON M FETALVERO is a Licensed Practical Nurse healthcare provider located in CANOGA PARK, California. NPI 1356953848 is currently active in the NPPES registry. Verify at CMS.

Licensed Practical Nurse · CANOGA PARK, CA

Registration Details

NPI Number
1356953848
Provider Type
Individual
Gender
Male
NPI Issued
Aug 18, 2020 (6.0158907659212 yrs)
Last Updated
May 21, 2021
License
218256 (CA)
Sole Proprietor
Yes

Practice Information

Address
7246 REMMET AVE
CANOGA PARK, CA, 913031531
Browse CA providers · Browse ZIP 91303
Phone
8182060630
Primary Specialty
Licensed Practical Nurse
164W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.