Individual
SHANNA VAN DOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
29676 RANCHO CALIFORNIA RD, TEMECULA, CA 92591-5283
(951) 693-2704
(401) 652-1417
Mailing address
33443 SCARBOROUGH LN, TEMECULA, CA 92592-5632
(760) 594-1332
(401) 652-1417
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH30779
CA
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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