Individual
JASMINE LATASHA ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1069 BROADWAY AVE, SUITE201, SEASIDE, CA 93955-4996
(831) 392-1500
Mailing address
1755 SOTO ST, SEASIDE, CA 93955-3941
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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