Individual
FONDA CRANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1481 WINDSOR DR, SAN BERNARDINO, CA 92404-5416
(909) 361-6472
Mailing address
231 HASTINGS ST, REDLANDS, CA 92373-5077
(909) 528-7970
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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