Individual
CAROLINA FAYE PROFETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335-4219
(909) 252-4010
(900) 252-4055
Mailing address
1950 S SUNWEST LN STE 200, SAN BERNARDINO, CA 92408-3248
(909) 252-4010
(900) 252-4055
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
115869
CA
Other
Enumeration date
06/08/2022
Last updated
08/29/2023
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