Individual
JAE DOUGLAS TRUESDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
MA, MPH, CMPSS
Contact information
Practice address
15200 FOOTHILL BLVD, SAN LEANDRO, CA 94578-1013
(510) 352-9690
Mailing address
15200 FOOTHILL BLVD, SAN LEANDRO, CA 94578-1013
(510) 352-9690
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-YQHUXN
CA
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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