Individual provider · NPI-1

Michelle Penuelas, NP

Nurse Practitioner, Obstetrics & Gynecology · Fontana, CA

NPI number1104146166
StatusActive
Last updated in NPPESNov 30, 2021

Details

NPI
1104146166
Entity type
Individual (NPI-1)
Name
Michelle Penuelas
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Jun 1, 2010
Last updated
Nov 30, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LX0001X Nurse Practitioner, Obstetrics & Gynecology19462CAYes

Practice location

9961 Sierra Ave
Fontana, CA 92335-6720

Phone 909-427-5539

Mailing address

9961 Sierra Ave
Fontana, CA 92335-6720

Phone 909-427-5539

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