Individual
DEMETRA VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6075 CONE PEAK PL, FONTANA, CA 92336-4569
(909) 561-5180
(909) 452-8638
Mailing address
6075 CONE PEAK PL, FONTANA, CA 92336-4569
(909) 561-5180
(909) 452-8638
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
CA
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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