Individual
MARY EDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
190 E HIGHLAND AVE, SAN BERNARDINO, CA 92404-3658
(909) 882-4788
(877) 860-7268
Mailing address
200 OCEANGATE, SUITE 100, LONG BEACH, CA 90802-4317
(562) 499-6191
(562) 499-6171
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
20107
CA
Other
Enumeration date
01/18/2011
Last updated
09/23/2016
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