Individual
LAUREN MATSUMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
16465 SIERRA LAKES PKWY, FONTANA, CA 92336-1242
(909) 823-8000
Mailing address
11141 FLORENCE LN, LOMA LINDA, CA 92354-6562
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
745202
CA
Other
Enumeration date
09/24/2015
Last updated
09/19/2018
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