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1144535980
SHANA PUTNAM
FONTANA, CA
NPI
1144535980
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Former Name
SHANA WANG
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA22069)
Enumeration Date
2010-08-17
Last Update Date
2021-10-27
Business Address
SHANA PUTNAM PA-C
9961 SIERRA AVE
FONTANA, CA 92335-6720
Phone number: 909-724-2321
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Mailing Address
SHANA PUTNAM PA-C
523 EMERSON ST
UPLAND, CA 91784-1341
Phone number: 626-235-3845
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