Individual
BEVERLY KIM DIZON AGNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 W AVENUE J, LANCASTER, CA 93534-2814
(661) 949-5000
Mailing address
44158 SIERRA VISTA DR, LANCASTER, CA 93536-6297
(818) 805-8523
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95244261
CA
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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