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General NPI Number Information
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NPI Number | 1982447108
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Entity Type | Individual
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Provider Name | ELISA EUNJEA RIOS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2024
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 1281 W C ST STE 200
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City | COLTON
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State | CA
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Zip | 92324-1916
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Country | US
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Telephone | 909-679-2754
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Fax | 909-906-9025
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Provider Business Mailing Address
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Address Line | 1281 W C ST STE 200
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City | COLTON
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State | CA
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Zip | 92324-1916
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Country | US
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Telephone | 909-679-2754
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Fax | 909-906-9025
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95039858
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License Number State | CA
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