# LOMA LINDA UNIVERSITY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912033846
- **Authorized official:** MS. MARY JO VOLLMER-SANDHOLM MSN, RN, CPNP (PEDIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (909) 558-8514

## Contact information

- **Practice address:** 11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
- **Practice address phone:** (909) 558-8514
- **Mailing address:** 25123 DAISY AVE, LOMA LINDA, CA 92354-3510
- **Mailing address phone:** (909) 266-0962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | 533452 | CA | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 08/22/2020