Wanda

NPI 1538322656 - Residential Treatment Facility, Physical Disabilities - 320700000X

NPI Details
NPI 1538322656
Enumeration Date 07/09/2008
Last Updated 07/09/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name WANDA JEAN WANDA
Position LVN
Phone (909) 823-3703
Fax (909) 823-3703
Practice Location
3730 FERNWOOD AVE
RIALTO CA, 92377-2724, US
Phone (909) 823-3703
Fax (909) 823-3703
Business Location
3730 FERNWOOD AVE
RIALTO CA, 92377-2724, US
Phone (909) 823-3703
Fax (909) 823-3703
Toxanomy
Taxonomy Code 320700000X
License State California
License Number 320700000X
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According to our database, Wanda NPI is 1538322656, taxonomy code is 320700000X and license number is 320700000X, license state is located at California. Wanda physically located at 3730 Fernwood Ave, Rialto CA, 92377-2724. NPI Number 1033115704 has the healthcare provider type.

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1538322656 NPI number is provided on an as is basis without warranty of any kind. 1538322656 is maintained by the National Plan & Provider Enumeration System. The contents of Wanda are for informational purposes only.