Individual
MRS. ELBA ONTIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7648 OLEANDER AVE, FONTANA, CA 92336-1935
(909) 357-6976
Mailing address
7648 OLEANDER AVE, FONTANA, CA 92336-1935
(909) 357-6976
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
INTERN
CA
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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