Individual
AMBER ASHLEY P TACDERAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 S WILLOW AVE, RIALTO, CA 92376-6934
(909) 820-8150
Mailing address
16254 LOZANO ST UNIT 3, FONTANA, CA 92336-6315
(909) 275-4618
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95230119
CA
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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