Individual
AFRIELLE FONDEVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1900 W GARVEY AVE S STE 166, WEST COVINA, CA 91790-2653
(626) 960-1402
Mailing address
1900 W GARVEY AVE S STE 166, WEST COVINA, CA 91790-2653
(626) 960-1402
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95010453
CA
Other
Enumeration date
02/25/2019
Last updated
09/21/2023
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