Individual
MARY I DALLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1800
Mailing address
1809 W REDLANDS BLVD, REDLANDS, CA 92373-8085
(909) 289-4075
(909) 363-8233
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95183118
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95034751
CA
Other
Enumeration date
06/25/2021
Last updated
01/09/2026
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