Shallowhorn, Jontia
Shallowhorn, Jontia is an sole proprietor health care provider with primary practice located at 26929 Nucia Dr , Moreno Valley CA 92555-4983. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Agencies / Home Health. Agencies / Home Health is her primary health care specialty. Shallowhorn, Jontia can be contacted via phone (661) 492-4743.Contact Information
Primary practice address
26929 Nucia Dr
Moreno Valley CA 92555-4983
Phone: (661) 492-4743
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Military Health Care Provider | 171000000X | B9256240 | California |
| Agencies / Home Health | 251E00000X |
Profile Details
| NPI number | 1518518745 |
|---|---|
| LBN Legal business name | Shallowhorn, Jontia |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 29th, 2019 |
| Last updated | Sep 29th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518518745 | NPPES |
| California | Other | B9256240 | CALIFORNIA DRIVER'S LICENSE |
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