Individual provider · Type 1 NPI

Kandise Jamerson

Meals Provider · Fontana, CA

NPI number 1104747989 Active

Practice location

15484 Vanilla Bean Ln
Fontana, CA 92336-3459

Call (951) 488-5034 Map

Specialties and licenses

TaxonomyCodeLicense
Meals Provider Primary 174200000XNone listed

Meals Provider: A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.

About NPI 1104747989

Kandise Jamerson's National Provider Identifier is 1104747989, issued on Jul 24, 2026. The primary taxonomy on file is Meals Provider (174200000X), and the practice location is in Fontana, CA. The record was last updated on Jul 24, 2026.