Individual
JEVON HETLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2222 N SANTIAGO BLVD, ORANGE, CA 92867-2552
(714) 998-5151
Mailing address
315 E BUFFALO AVE, SANTA ANA, CA 92706-2950
(714) 998-5151
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000005760
CA
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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