Individual
EDNA KARINA FAVELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., CDE
Contact information
Practice address
12168 MOUNT VERNON AVE UNIT 80, GRAND TERRACE, CA 92313-5545
(909) 638-3272
Mailing address
12168 MOUNT VERNON AVE UNIT 80, GRAND TERRACE, CA 92313-5545
(909) 638-3272
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
1000367
CA
174H00000X
Health Educator
21420614
CA
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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