Individual
EDIKA WITHINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3148 BELVEDERE DR, RIVERSIDE, CA 92507-3205
(951) 788-0940
Mailing address
16075 GERANIUM CT, MORENO VALLEY, CA 92551-7293
(951) 345-2646
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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