Individual
JACQUELYN A BRACEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 W 213TH ST STE 100, TORRANCE, CA 90501-2852
(310) 328-0276
Mailing address
22028 CALLAHAN PL, CARSON, CA 90745-3534
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16936
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/20/2016
Last updated
03/10/2017
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