Individual
CHERI LYNNE PONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6181 N THESTA ST STE 104, FRESNO, CA 93710-8604
(559) 825-0300
(559) 825-0301
Mailing address
2409 ARTESIA BLVD FL 2, REDONDO BEACH, CA 90278-3207
(424) 276-4700
(424) 903-1099
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
51641
CA
363A00000X
Physician Assistant
Primary
51641
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1084991
NCCPA
—
Enumeration date
12/01/2008
Last updated
03/17/2018
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