Individual
ABIGAIL MONDRAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
940 E WILLIAMS ST SUITE 102, BANNING, CA 92220
(951) 588-2553
(951) 755-8992
Mailing address
940 E WILLIAMS ST SUITE 102, BANNING, CA 92220
(951) 588-2553
(951) 755-8992
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-DCHAEP
CA
Other
Enumeration date
12/04/2023
Last updated
07/09/2024
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