Provider Demographics
NPI:1033731443
Name:STANTON, JONI LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:LYNN
Last Name:STANTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JONI
Other - Middle Name:LYNN
Other - Last Name:DE VERA-STANTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1317 CAMBON CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-5447
Mailing Address - Country:US
Mailing Address - Phone:909-205-4622
Mailing Address - Fax:
Practice Address - Street 1:11201 BENTON ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92357-1000
Practice Address - Country:US
Practice Address - Phone:909-825-7084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95214709163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice