Individual
FAAUIAO FILI FANUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13800 HEACOCK ST, MORENO VALLEY, CA 92553-3339
(213) 782-9521
Mailing address
13800 HEACOCK ST, MORENO VALLEY, CA 92553-3339
(213) 782-9521
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
713005
CA
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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