Individual
IDONGESIT J STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
12598 CENTRAL AVE STE 219, CHINO, CA 91710-3530
(909) 591-1444
Mailing address
13421 SUMTER ST, FONTANA, CA 92336-5425
(909) 331-8360
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95005848
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95005848
CA
Other
Enumeration date
11/02/2017
Last updated
09/28/2021
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