Individual
NICOLE HANNAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9631 BUSINESS CENTER DR., BLDG. 14, STE. D, RANCHO CUCAMONGA, CA 91730
(909) 948-5747
(909) 361-4848
Mailing address
9645 ARROW RTE., BLDG. 5, STE. A, RANCHO CUCAMONGA, CA 91730
(909) 948-5747
(909) 948-5746
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
06/11/2025
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