Individual
DAWN ERICA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335
(951) 961-6575
Mailing address
5057 TROJAN COURT, RIVERSIDE, CA 92507-6056
(951) 358-6437
(951) 358-4719
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
597385
CA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
597385
CA
Other
Enumeration date
12/05/2017
Last updated
04/26/2019
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