Individual
INGRID HERNANDEZ LASCANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 W LA VETA AVE STE 450, ORANGE, CA 92868-4224
(949) 267-0316
Mailing address
11758 VISTA VERDE ST, VICTORVILLE, CA 92392-0401
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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