Provider Demographics
NPI:1649905357
Name:TOWNS, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:TOWNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14050 CHERRY AVE STE.R92
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337
Mailing Address - Country:US
Mailing Address - Phone:909-714-0480
Mailing Address - Fax:
Practice Address - Street 1:14050 CHERRY AVE STE.R92
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337
Practice Address - Country:US
Practice Address - Phone:909-714-0480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver