Healthcare Provider Details

I. General information

NPI: 1407438914
Provider Name (Legal Business Name): CHELSEA CIERRA PAMBIANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

987 W FOOTHILL BLVD STE 202A-15
CLAREMONT CA
91711-3357
US

IV. Provider business mailing address

258 W DAYTON ST
UPLAND CA
91786-3121
US

V. Phone/Fax

Practice location:
  • Phone: 760-447-3194
  • Fax:
Mailing address:
  • Phone: 760-447-3194
  • 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:
Title or Position:
Credential:
Phone: