Individual
MS. JEANELLE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
654 JENEVEIN AVE, SAN BRUNO, CA 94066-4230
(650) 877-0999
Mailing address
29 MORTON DR, DALY CITY, CA 94015-4415
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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