Individual
ELIZABETH OTILIA RENTERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1040 N ROSE ST, ESCONDIDO, CA 92027-1523
(760) 807-9013
Mailing address
1040 N ROSE ST, ESCONDIDO, CA 92027-1523
(760) 807-9013
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN236790
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A2223665
DRIVERS LICENSE
CA
Enumeration date
12/15/2009
Last updated
12/15/2009
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