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NPI 1104307594 · Nursing Care Agency · Grand Terrace, CA
Provider details
- NPI number
- 1104307594
- Entity type
- Organization
- Primary specialty
- Nursing Care AgencyAgencies
- Organization subpart
- No
- Authorized official
- Frenalyn Domingo, Owner(909) 709-7941
- License
- NP13242 (CA)
Specialties & taxonomies
Agencies
Practice location
22040 Van Buren St
Grand Terrace, CA 92313-5608
Phone: (909) 709-7941
Fax: (888) 519-0834
Approximate (ZIP-level) locationGet directions
Mailing address
25612 Barton Rd # 335
Loma Linda, CA 92354-3110
Registry dates
- Enumerated
- 2018-08-24
- Last updated
- 2018-08-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.