Individual
AMY ROSE PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2940 INLAND EMPIRE BLVD, ONTARIO, CA 91764-4898
(909) 458-1350
Mailing address
7476 SHORTHORN ST, CHINO, CA 91708-9113
(909) 957-6771
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95162544
CA
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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