Individual
ANNELIESE MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 CORPORATE CENTER DR STE 202, POMONA, CA 91768-2627
(909) 760-7060
Mailing address
8600 BELLA VISTA DR, ALTA LOMA, CA 91701-1306
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
287804
CA
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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