Individual
BRYANNA DAVALOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 W LA CADENA DR, RIVERSIDE, CA 92501-1413
(951) 784-8010
Mailing address
1021 W LA CADENA DR, RIVERSIDE, CA 92501-1413
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
702126
CA
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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