Individual
JESSICA QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 CARMEN LN STE 201, SANTA MARIA, CA 93458-7771
(805) 212-7680
(805) 728-9492
Mailing address
212 CARMEN LN STE 201, SANTA MARIA, CA 93458-7771
(805) 212-7680
(805) 728-9492
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
05/29/2018
Last updated
05/14/2025
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