Individual
JEREMY JUSTIN TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2050 FAIRMONT DR, SAN LEANDRO, CA 94578-1001
(510) 924-0548
Mailing address
400 ESTUDILLO AVE STE 100, SAN LEANDRO, CA 94577-4962
(510) 924-0548
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
716058
CA
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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