Healthcare Provider Details

I. General information

NPI: 1952048845
Provider Name (Legal Business Name): VICTORIA ROSE ARGANDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11424 CHAMBERLAINE WAY # 11-12
ADELANTO CA
92301-2869
US

IV. Provider business mailing address

2415 VALENCIA AVE
SAN BERNARDINO CA
92404-4035
US

V. Phone/Fax

Practice location:
  • Phone: 760-246-0934
  • Fax:
Mailing address:
  • Phone: 909-258-8259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberF7057003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: