MARIE V DETHOMAS, NP, Pediatrics RANCHO CUCAMONGA, CA

Contact Information

MARIE V DETHOMAS, NP

10399 LEMON AVE STE 101
RANCHO CUCAMONGA, CA 91737-3771

Phone: 909-466-7337
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Pediatrics	363LP0200X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for MARIE V DETHOMAS · (Female)

NPI Number	`1811353196`
Status	Active
Credentials	NP (Nurse Practitioner)
Entity	Individual
Enumeration date	01/03/2016
Last updated	01/03/2016 - About 10 years ago
Sole proprietor ¹	No
Identifiers	CA License # 95002884
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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