Individual
DEANNA OTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 MOLLY LOOP, LADERA RANCH, CA 92694-0803
(951) 233-2603
Mailing address
12 MOLLY LOOP, LADERA RANCH, CA 92694-0803
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95037162
CA
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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