Individual
MARTINIQUE N CISNEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
826 S OAKS AVE, ONTARIO, CA 91762-4732
(909) 247-5842
Mailing address
826 S OAKS AVE, ONTARIO, CA 91762-4732
(909) 247-5842
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
740538
CA
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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