Individual
WENDI SHARLENE GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
850 E FOOTHILL BLVD, RIALTO, CA 92376-5230
(909) 421-9255
Mailing address
PO BOX 204, FOREST FALLS, CA 92339-0204
(909) 421-9255
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
662801
CA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
662801
CA
163WP0000X
Pain Management Registered Nurse
662801
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
662801
CA
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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