Individual
MS. SHANTELL MONIQUE POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
719 W 58TH ST, LOS ANGELES, CA 90037-4033
(951) 230-6728
Mailing address
PO BOX 213093, CHULA VISTA, CA 91921-3093
(888) 417-5163
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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