Individual
JAYLENE STA ANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
9764 GARDEN GROVE BLVD, GARDEN GROVE, CA 92844-1615
(714) 534-0007
Mailing address
9764 GARDEN GROVE BLVD, GARDEN GROVE, CA 92844-1615
(714) 534-0007
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4584
CA
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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