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Organization
LOMA LINDA UNIVERSITY MEDICAL CENTER
Active
Organization
LOMA LINDA UNIVERSITY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY JO VOLLMER-SANDHOLM MSN, RN, CPNP (PEDIATRIC NURSE PRACTITIONER)
(909) 558-8514
Entity
Organization
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-8514
Mailing address
25123 DAISY AVE, LOMA LINDA, CA 92354-3510
(909) 266-0962
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
533452
CA
Other
Enumeration date
02/26/2007
Last updated
08/22/2020
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