Individual
MS. EYVONNE JACSKON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
507 ELLIS ST, LAKE ELSINORE, CA 92530-3828
(951) 491-4907
Mailing address
507 ELLIS ST, LAKE ELSINORE, CA 92530-3828
(951) 491-4907
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN222175
CA
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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