Ann Marie C Acosta

Individual provider Active NPI Licensed Vocational Nurse · Upland, CA

NPI 1316634645 · NPPES record last updated Apr 18, 2023

Key facts

NPI
1316634645
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
690837 (CA)
Practice address
1241 W Foothill Blvd
Upland, CA 91786-3681
Phone
(909) 985-2713
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
690837CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 690837 CA Yes

Addresses

Primary practice location

1241 W Foothill Blvd
Upland, CA 91786-3681

Mailing address

1241 W Foothill Blvd
Upland, CA 91786-3681
Phone (909) 985-2713

Other providers in Upland, CA

All providers in Upland, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.