Individual
EVANGELINA JACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1820 BETHANY AVE, SAN JOSE, CA 95132-1514
(408) 250-2568
(408) 729-3282
Mailing address
1824 BETHANY AVE, SAN JOSE, CA 95132-1514
(408) 250-2568
(408) 729-3282
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
435201652
CA
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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