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1336649060
KRISTINE GRACE LEE DIZON
COVINA, CA
NPI
1336649060
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA NP95007409)
Enumeration Date
2018-02-19
Last Update Date
2018-02-19
Business Address
KRISTINE GRACE LEE DIZON FNP-C
110 N 4TH AVE
COVINA, CA 91723-1825
Phone number: 626-859-6400
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Mailing Address
KRISTINE GRACE LEE DIZON FNP-C
14896 OAK LEAF DR
CORONA, CA 92880-1049
Phone number:
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