Individual
DR. JESSICA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DVM
Contact information
Practice address
3559 W RAMSEY ST, BANNING, CA 92220-3505
(951) 849-3864
Mailing address
3559 W RAMSEY ST, BANNING, CA 92220-3505
(951) 849-3864
Taxonomy
Speciality
Code
Description
License number
State
174M00000X
Veterinarian
Primary
19295
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19295
CALIFORNIA VETERINARY BOARD LICENSE
CA
Enumeration date
05/18/2013
Last updated
05/18/2013
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