Deryk Mason II, LVN
Licensed Vocational Nurse in Upland, CA. Individual provider (NPI-1).
NPI number1457045346
StatusActive
Last updated in NPPESJun 5, 2023
Details
- NPI
- 1457045346
- Entity type
- Individual (NPI-1)
- Name
- Mr. Deryk Mason II
- Credential
- LVN
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 5, 2023
- Certification date
- Jun 5, 2023
- Last updated
- Jun 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164X00000X | Licensed Vocational Nurse | 287724 | CA | Yes |
Practice location
1241 W Foothill BlvdUpland, CA 91786-3681
Phone 909-985-2713
Mailing address
11474 Tioga Peak CtRancho Cucamonga, CA 91737-8804
Phone 909-313-1192
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All 21 Licensed Vocational Nurse providers in Upland · All 2,782 providers in Upland
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