Individual
KATHI SALLEY RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNC, MSN, CNS, NNP
Contact information
Practice address
28141 BELLETERRE AVE, MORENO VALLEY, CA 92555-6223
(909) 558-4403
Mailing address
28141 BELLETERRE AVE, MORENO VALLEY, CA 92555-6223
(909) 558-4403
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
504615
CA
364SN0000X
Neonatal Clinical Nurse Specialist
1392
CA
Other
Enumeration date
03/07/2007
Last updated
09/11/2025
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