Individual
JESSICA JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13950 MILTON AVE, WESTMINSTER, CA 92683-2900
(714) 901-4629
Mailing address
11503 NAVA ST, NORWALK, CA 90650-6318
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
202361
CA
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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