Individual
JARED CHRISTIAN SUPNET MAURICIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 W COLUMBUS ST, BAKERSFIELD, CA 93301-1263
(661) 328-0245
Mailing address
11410 TRABANCOS DR, BAKERSFIELD, CA 93311-2160
(661) 328-0245
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
750917
CA
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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