Individual
STEPHANIE KUMALAO RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15027 MANNING ST, VICTORVILLE, CA 92394-1033
(818) 259-9107
Mailing address
15027 MANNING ST, VICTORVILLE, CA 92394-1033
(818) 259-9107
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
365530050
CA
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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