Individual
JACLYN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 E 24TH ST, NATIONAL CITY, CA 91950-6705
(619) 474-6741
Mailing address
822 SAN JUAN PL APT 1, SAN DIEGO, CA 92109-7356
(848) 459-0916
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19736
CA
Other
Enumeration date
03/05/2019
Last updated
03/18/2019
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