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Individual

CRYSTAL AMANDA WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12023 3RD ST, YUCAIPA, CA 92399-2743
(626) 633-7854
Mailing address
1551 DODGE WAY, NORCO, CA 92860-3885
(626) 633-7854

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Enumeration date
04/12/2023
Last updated
04/12/2023
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