Individual
MRS. JACQUELYN LUCERO NASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
1645 DONLON ST STE 102, VENTURA, CA 93003-5667
(805) 339-0670
Mailing address
1645 DONLON ST STE 102, VENTURA, CA 93003-5667
(805) 339-0670
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
04331
CA
224P00000X
Prosthetist
04331
CA
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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