Individual
ANN JAHOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
792 AVOCADO AVE UNIT 15, EL CAJON, CA 92020-6473
(619) 396-8059
Mailing address
792 AVOCADO AVE UNIT 15, EL CAJON, CA 92020-6473
(619) 396-8059
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3016923500
MEDI-CAL PROGRAM
—
Enumeration date
10/29/2015
Last updated
10/29/2015
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