Individual
EVIE SIREGAR SITORUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11201 BENTON ST, LOMA LINDA, CA 92357-1000
(909) 825-7084
Mailing address
241 E CAROL WAY, SAN BERNARDINO, CA 92408-4195
(909) 825-7084
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95361922
CA
Other
Enumeration date
06/19/2025
Last updated
06/19/2025
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