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Individual

MS. DEBORAH J GOMEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
427 N EUCLID AVE, ONTARIO, CA 91762-3427
(909) 957-6818
Mailing address
427 N EUCLID AVE, ONTARIO, CA 91762-3427
(909) 957-6818

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FBN2090011542
FICTITIOUS BUSINESS NUMBER
CA
Enumeration date
12/30/2019
Last updated
12/30/2019
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