Healthcare Provider Details

I. General information

NPI: 1205747490
Provider Name (Legal Business Name): PONTE NUTRITION CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 EDISON AVE. STE 200 SUITE 110
CHINO CA
91710-8410
US

IV. Provider business mailing address

4110 EDISON AVE STE 200 SUITE 110
CHINO CA
91710-8410
US

V. Phone/Fax

Practice location:
  • Phone: 562-646-9474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: JENJIRA SORRECA DO
Title or Position: PRESIDENT
Credential: RD
Phone: 562-646-9474