Individual
VIVIAN LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2180 VALLEY BLVD, POMONA, CA 91768-3325
(909) 865-2336
Mailing address
10408 FELIPE AVE, MONTCLAIR, CA 91763-4394
(909) 305-3570
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
95033292
CA
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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