Individual
JADE KENZIE ELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14850 CENTRAL AVE, CHINO, CA 91710-9509
(909) 597-0504
Mailing address
1215 HILLMAR DR, DIAMOND BAR, CA 91765-2414
(909) 633-1913
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
CA
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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