Individual
DENISE E ILDEFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R. N.
Contact information
Practice address
952 N MORGAN ST, ORANGE, CA 92867-7554
(714) 319-6919
Mailing address
952 N MORGAN ST, ORANGE, CA 92867-7554
(714) 319-6919
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
584807
CA
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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