Individual provider · Type 1 NPI
Marie Veronica Dethomas, NP
Pediatric Nurse Practitioner · Rancho Cucamonga, CA
NPI number
1811353196
Active
Practice location
10399 Lemon Ave Ste 101
Rancho Cucamonga, CA 91737-3771
Mailing address
12931 Evermay Ct
Rancho Cucamonga, CA 91739-9244
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 95002884 (CA) |
Pediatric Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1811353196
Marie Veronica Dethomas, NP's National Provider Identifier is 1811353196, issued on Jan 3, 2016. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Rancho Cucamonga, CA. The record was last updated on Jan 3, 2016.