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General NPI Number Information
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NPI Number | 1073275210
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Entity Type | Individual
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Provider Name | ANNETTE NICOLE HUERTA
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Gender | Female
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 268 MCARTHUR WAY
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City | UPLAND
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State | CA
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Zip | 91786-5615
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Country | US
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Telephone | 909-406-5353
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Fax |
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Provider Business Mailing Address
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Address Line | 12659 WESTWAY
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City | VICTORVILLE
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State | CA
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Zip | 92392-0511
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Country | US
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Telephone | 626-675-5506
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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