Individual
DEZIREE NICOLE NICOTHODES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2243 N MOUNTAIN AVE, CLAREMONT, CA 91711-1586
(909) 544-1676
Mailing address
2720 FOUNTAIN ST, POMONA, CA 91767-2246
(909) 544-1676
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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