Healthcare Provider Details

I. General information

NPI: 1750825667
Provider Name (Legal Business Name): JOYCE LOZANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 12/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 RIO RANCHO RD STE 120
POMONA CA
91766-7015
US

IV. Provider business mailing address

3360 HOLDING ST
RIVERSIDE CA
92501-2207
US

V. Phone/Fax

Practice location:
  • Phone: 909-242-7989
  • Fax:
Mailing address:
  • Phone: 951-536-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: