Individual
KANDISE JAMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15484 VANILLA BEAN LN, FONTANA, CA 92336-3459
(951) 488-5034
Mailing address
15484 VANILLA BEAN LN, FONTANA, CA 92336-3459
(951) 488-5034
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
Other
Enumeration date
07/24/2026
Last updated
07/24/2026
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