Most Relevant Information
Provider Data
| NPI Number: | 1003271149 |
| Provider Name: | LORENA LLANET TOVAR FUENTES PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP0808X |
| Specialty: | Registered Nurse |
| License Number: | 764782 |
Most Important Dates
| Enumeration Date: | 12/16/2015 |
| Last Updated: | 08/16/2023 |
Provider Practice Location
415 W ROUTE 66 STE 202
GLENDORA
CA
917404335
Practice Location Phone/Fax
| Phone: | 6269634467 |
| Fax: | 6269639543 |
Provider Mailing Location
415 W ROUTE 66 STE 202
GLENDORA
CA
917404335
Provider Mailing Phone/Fax
| Phone: | 6269634467 |
| Fax: | 6269639543 |