Individual
MARILYN DENISE PONCE DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SCHOOL NURSE
Contact information
Practice address
1170 CHESS DR, FOSTER CITY, CA 94404-1107
(650) 638-2973
Mailing address
845 SHELL BLVD APT 102, FOSTER CITY, CA 94404-2550
(909) 744-2921
(650) 655-3394
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
160250571
CA
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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