Individual
ANN MARIE C ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1241 W FOOTHILL BLVD, UPLAND, CA 91786-3681
(909) 985-2713
Mailing address
1241 W FOOTHILL BLVD, UPLAND, CA 91786-3681
(909) 985-2713
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
690837
CA
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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