Individual
MRS. FAIR ANTONETTE TANADA ESPELITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CPN
Contact information
Practice address
1053 RAYNOR ST, COLTON, CA 92324-7520
(909) 735-1121
Mailing address
1053 RAYNOR ST, COLTON, CA 92324-7520
(909) 735-1121
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
671069
CA
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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