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NPI Code Detail

MEDICARE: ANDREA CHRISTINE UPTON

MEDICARE: ANDREA CHRISTINE UPTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational NurseLVN263227CA

General Provider Information

NPI Number : 1619229572
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA CHRISTINE UPTON
Provider Business Mailing Address
First Line : 940 AVENUE 64
Second Line :
City : PASADENA
State : CA
Zip : 91105-2711
Country : US
Telephone Number : 323-254-2274
Fax Number :
Provider Business Practice Location Address
First Line : 18612 SANTA ANA AVE
Second Line :
City : BLOOMINGTON
State : CA
Zip : 92316-2639
Country : US
Telephone Number : 909-421-7120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2012
Last Update Date : 03/27/2024

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Directions to “ ANDREA CHRISTINE UPTON ” Practice Location

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