Individual
RANELL LONGSHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9890 COUNTY FARM RD STE 3, RIVERSIDE, CA 92503-3678
(909) 999-1626
Mailing address
9890 COUNTY FARM RD STE 3, RIVERSIDE, CA 92503-3678
(909) 999-1626
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37237
CA
Other
Enumeration date
07/11/2024
Last updated
09/27/2024
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