Individual
TANYA RENEE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19166 LA QUINTA PL, APPLE VALLEY, CA 92308-2700
(760) 887-0477
Mailing address
19166 LA QUINTA PL, APPLE VALLEY, CA 92308-2700
(760) 887-0477
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
802219
CA
Other
Enumeration date
09/19/2019
Last updated
06/27/2025
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