Individual
AJA LATYOA SEALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14677 MERRIL AVENUE, FONTANA, CA 92335
(951) 643-2340
Mailing address
2669 W VIA SAN MIGUEL, SAN BERNARDINO, CA 92410-1969
(909) 714-9889
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN692184
CA
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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